Abandoning combined-modality therapy in favor of chemotherapy alone negatively affects patient survival, according to a study of 59,225 patients with diffuse large B-cell lymphoma (DLBCL). Researchers found:

• Only 39% of patients received combined-modality therapy.

• Treatment selection was significantly influenced by race, comorbidity, insurance type, education quartile, facility type, age, stage, B symptoms, distance from treatment facility, and year of diagnosis.

• Estimated 5-year and 10-year overall survival (OS) rates were, respectively: 79% and 59% for all patients; 75% and 55% for patients receiving chemotherapy alone; and 82% and 64% for patients receiving combined-modality therapy.

• Even after adjusting for immortal times and indication bias, combined-modality therapy was associated with better OS (hazard ratio, 0.66) than was chemotherapy alone.

Citation: Vargo JA, Gill BS, Balasubramani GK, Beriwal S. Treatment selection and survival outcomes in early-stage diffuse large B-cell lymphoma: Do we still need consolidative radiotherapy? [Published online ahead of print August 10, 2015]. J Clin Oncol. doi: 10.1200/JCO.2015.61.7654.