CLINICAL EFFICACY OF RITUXIMAB COMBINED WITH CHOP REGIMEN SEQUENTIAL OR NON-SEQUENTIAL LOCAL RADIOTHERAPY IN PATIENTS WITH STAGE III-IV DIFFUSE LARGE B-CELL LYMPHOMA

Daorui Lin^{1, #}, Yang Wen^{1, #}, Zhuangyan Mai^{2, *}

¹Department of Medical Oncology, the First Affiliated Hospital of Hainan Medical University, Haikou, Hainan 570102 China - ²Department of Medical Oncology, Hainan West Central Hospital, Danzhou, Hainan 571700, China

Introduction: To probe the clinical efficacy of rituximab combined with CHOP regimen sequential or non-sequential local radiotherapy in patients with stage III-IV diffuse large B-cell lymphoma.

Materials and methods: The clinical data of 126 patients with high-risk DLBCL in The First Affiliated Hospital of Hainan Medical University from January 2018 to December 2021 were retrospectively analyzed. Among them, 42 patients were adopted CHOP regimen alone as the CHOP group, 38 patients were adopted sequential or no sequential local radiotherapy with CHOP regimen as the radiotherapy group, and 46 patients were adopted rituximab combined with CHOP regimen plus sequential or no sequential local radiotherapy were included in the combined group. The patients in the CHOP group were adopted the CHOP regimen, the patients in the radiotherapy group were adopted radiotherapy in addition to the CHOP regimen, and the patients in the combined group were treated with rituximab in addition to the radiotherapy group. The short-term and long-term efficacy, adverse reactions and immunoglobulin levels were compared in these three groups.

Results: In comparison with the CHOP group, the total effective rate of the combined group and radiotherapy group was elevated, and the whole effective rate of combined group was increased relative to the radiotherapy group. There was no patient who stopped treatment within 6 courses in the three groups, and no difference was observed in the occurrence of adverse events among the three groups. Before treatment, no difference was discovered in the immunoglobulin levels among the three groups (P>0.05). After treatment, IgG, IgA and IgM levels in the radiotherapy group as well as the combined group were reduced compared to those before chemotherapy (P<0.05). IgG, IgA and IgM levels in the CHOP group were not significantly different from those before chemotherapy (P>0.05). After treatment, the levels of IgG, IgA, and IgM in the combined group were declined relative to the CHOP group and the radiotherapy group (P<0.05). The PFS of the combined group was 71.90%, and the radiotherapy group was 51.30%, which was higher than 39.30% of the CHOP group (x²=7.643, P=0.006). The OS rate of the combined group was 81.30%, and the radiotherapy group was 54.80%, which was higher than 42.90% of the control group. Spearman correlation analysis unveiled that the clinical efficacy of the radiotherapy group together with the combined group was negatively correlated with the serum IgM level after 4 courses and 6 courses of treatment.

Conclusion: Rituximab combined with radiotherapy is effective in DLBCL therapy, which can significantly promote the short-term efficacy of patients with high safety.