VIDEO: Omitting radiotherapy in primary mediastinal B-cell lymphoma does not hinder outcome
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CHICAGO — In this video, Emanuele Zucca, MD, discusses the IELSG37 trial supporting the omission of mediastinal radiotherapy in patients with primary mediastinal B-cell lymphoma who achieve complete metabolic response after chemotherapy.
At the ASCO Annual Meeting, Zucca, scientific and medical director of the International Extranodal Lymphoma Study Group, discussed how mediastinal radiotherapy increases the risk for second malignancies and coronary or valvular heart disease.
“Radiation therapy ... also comes with a risk for second cancers and cardiac-related events,” Zucca said. “We have seen in a randomized study that the difference between radiation therapy and observation only is minimal.”
In this prospective study, 268 patients with primary mediastinal B-cell lymphoma achieved complete metabolic response and were randomly allocated to either observation only (132 patients) or radiotherapy (136 patients). PFSl at 30 months was 98.5% in the radiotherapy arm and 96.2% in the observation arm.
“This difference is statistically not significant and clinically not relevant since the overall survival of patients at 5 years from diagnosis is identical in both arms and is extremely high — 99%,” Zucca said. “Patients achieving complete response after standard immunochemotherapy with a regimen containing both rituximab and doxorubicin should no longer be irradiated. It is safe just to observe,” Zucca continued.
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Zucca E, et al. Abstract LBA7505. Presented at: ASCO Annual Meeting; June 2-6, 2023; Chicago.
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