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The role of rituximab in combination with CHOP-like chemotherapy regimens in patients with stage I diffuse large-B cell lymphoma remains to be defined.We aimed to compare CHOP-like chemotherapy and rituximab (R-CHOP) with CHOP-like chemotherapy alone in these patients.We retrospectively analyzed 140 untreated patients with stage I diffuse large-B-cell lymphoma (DLBCL).Seventy-eight patients were treated by R-CHOP regimen and 62 patients received CHOP-like chemotherapy alone.Ninety-one patients received additional radiotherapy at the end of chemotherapy.Median age at diagnosis was 52 years.Complete remission (CR) rate was 77% both in patients received R-CHOP chemotherapy and in patients with CHOP-like chemotherapy.After a median follow-up of 55 months,patients received R-CHOP chemotherapy had similar 5-year progression-free survival (PFS) (76% vs 85%; log-rank P=0.215) and 5-year overall survival (90% vs 96%; log-rank P=0.175) compared with those with CHOP-like chemotherapy alone.Patients with radiotherapy had significantly increased 5-year PFS compared with those who had chemotherapy alone (86% vs 71 %; log-rank P=0.005).These results suggest that CHOP- like chemotherapy alone could be as effective as R-CHOP chemotherapy and additional radiotherapy is necessary for stage I DLBCL patients.