| Title: |
Optimally Delivered R-da-EPOCH Versus R-CHOP-21 in Primary Mediastinal Large B-Cell Lymphoma: A Real-Life Comparison in a Single Academic Center |
| Authors: |
Alexia Piperidou; Maria K. Angelopoulou; Chrysovalantou Chatzidimitriou; John V. Asimakopoulos; Maria Arapaki; Fotios Panitsas; Gerassimos Tsourouflis; Marina Belia; Iliana Konstantinou; Anastasia Kopsaftopoulou; Athanasios Liaskas; Alexandros Machairas; Maria-Aikaterini Lefaki; Maria Dimitrakoudi; Sotirios Sachanas; Gerassimos A. Pangalis; Konstantinos Konstantopoulos; Eleni Plata; Marina Siakantaris; Theodoros P. Vassilakopoulos |
| Source: |
Cancers ; Volume 17 ; Issue 10 ; Pages: 1699 |
| Publisher Information: |
Multidisciplinary Digital Publishing Institute |
| Publication Year: |
2025 |
| Collection: |
MDPI Open Access Publishing |
| Subject Terms: |
Primary mediastinal; Large cell lymphoma; B-cell; R-da-EPOCH; R-CHOP-21; RT |
| Description: |
Background/Objectives: The National Cancer Institute introduced the intensified R-da-EPOCH regimen in primary mediastinal large B-cell lymphoma (PMLBCL) to improve outcomes while minimizing radiotherapy use. However, there is no randomized comparison of R-da-EPOCH vs. R-CHOP-21. The objective of this study was to compare R-da-EPOCH with R-CHOP-21 in consecutive patients with PMLBCL of a single, large referral center, where the R-da-EPOCH escalation schedule was strictly followed. Methods: We retrospectively analyzed all 35 consecutive patients who received R-da-EPOCH (2017–2022) compared to 35 consecutive patients treated with R-CHOP-21 arm at the same Department, starting from the most recent patient and going backwards (2005–2017). Results: R-da-EPOCH was given strictly in 33/35 (94%) patients. The 5-year freedom from progression (FFP) was 91% vs. 69% (p = 0.027). The 5-year event-free survival (EFS) was 84% vs. 69% (p = 0.124). The 5-year overall survival (OS) was 97% vs. 80% (p = 0.063). Among R-CHOP-21-responders, 20/29 (69%) received RT compared to 2/34 (6%) R-da-EPOCH-responders. In multivariate analysis, R-da-EPOCH remained better than R-CHOP-21 in terms of FFP [hazard ratios (HRs) 0.21–0.26, all p < 0.05] and was associated with very favorable HR for EFS and OS. Conclusions: Optimally delivered R-da-EPOCH minimized the use of RT in a real-life setting and provided superior outcomes than R-CHOP-21. |
| Document Type: |
text |
| File Description: |
application/pdf |
| Language: |
English |
| Relation: |
https://dx.doi.org/10.3390/cancers17101699 |
| DOI: |
10.3390/cancers17101699 |
| Availability: |
https://doi.org/10.3390/cancers17101699 |
| Rights: |
https://creativecommons.org/licenses/by/4.0/ |
| Accession Number: |
edsbas.F1A7F5EC |
| Database: |
BASE |