![]() Primary lymphoma of bone (PLB) was first reported as a distinct clinical entity by Parker and Jackson in 1984 ( 1). In the absence of randomized controlled trials, RT should be considered in ES disease with cautions of second cancers in specific subsets of patients. However, RT significantly elevated the late toxicities of second malignancies in ES patients diagnosed at the age of 18–39 or those with appendicular sites of bone involvement.Ĭonclusion: This population-based analysis is the largest PB-DLBCL dataset to date and demonstrates a significant survival benefit associated with RT in early stages rather than advanced stages. With short-term follow up in SEER 18, none of the subgroups showed a significantly elevated risk of developing SPMs. In subgroup analyses, OS was improved with RT in those who had ES disease ( p < 0.001) but not in those who had AS disease ( P = 0.776). Moreover, a novel web-based prediction model was established to individualize the potential benefit from RT. PSM analysis further validated the survival advantage of RT ( P = 0.018). RT significantly improved survival both in UVA and MVA ( P < 0.001, P = 0.010, respectively). Most patients in ES (63.9%) underwent RT, whereas only 42.2% of AS patients received it. A decreasing trend was observed in the ES cohort after 2002, while the rate of RT utilization remained stable in the AS cohort over the past three decades. Results: A total of 1,320 patients were identified, including 856 with early-stage (ES) and 464 with advanced-stage (AS). We calculated the standardized incidence ratio to estimate the short- and long-term risk for second primary malignancies (SPM) from 2002 to 2016 in SEER –2016 in SEER 9. The effect of RT on overall survival (OS) using univariate (UVA) and multivariate (MVA) Cox proportional regression and propensity score matching (PSM) was assessed for the entire cohort and subgroups by stages. Methods: We included adult patients with PB-DLBCL diagnosed from 2002 to 2016 from SEER 18. We used the SEER database to compare the outcomes among adult patients treated with and without RT in rituximab era. Whether radiotherapy (RT) should be omitted in the modern treatment of PB-DLBCL is still under debate. 3Fred Hutchinson Cancer Research Center, Seattle, WA, United Statesīackground: Primary bone B-cell lymphoma (PB-DLBCL) is a rare entity for which existing data is limited.2Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.1Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.Trial registration: identifier: NCT02815397.Shengling Ma 1 †, Yuanyuan Zhang 2 †, Ziying Li 1, Han Yan 1, Linghui Xia 1, Wei Shi 1,3 * and Yu Hu 1 * ![]() Trial registration: identifier: NCT02272686. Treatment intensification with RT may improve early stage DHL/THL outcomes. No differences in overall survival were observed between the treatment groups. Low-risk (R-IPI <2) DHL/THL patients treated with rituximab-based therapy had 3-year FFR rates of 11% and 71% for systemic therapy without and with RT, respectively p = .04. The median FFR for non-DHL/THL was not reached and was 33 and 22.3 months for DHL and THL, respectively p < .001. Systemic therapy without RT resulted in inferior freedom from relapse (FFR) (HR: 2.28 95% CI, 1.10–4.77 p = .02). This analysis included 183 patients profiled with fluorescent in situ hybridization (FISH) for alterations in MYC, BLC2, and/or BCL6. We investigated whether adding radiation (RT) to systemic therapy improved outcomes in early stage diffuse large B-cell lymphoma (DLBCL) patients with or without double- or triple-hit lymphoma (DHL/THL) biology.
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