Response to Low-dose Involved-field Radiotherapy in Patients with Non-Hodgkin's Lymphoma

Overview

Journal Ann Oncol

Publisher Elsevier

Specialty Oncology

Date 2008 Jul 24

PMID 18647962

Citations 11

Authors

S K Luthy

A K Ng

B Silver

K O Degnan

D C Fisher

A S Freedman

P M Mauch

Affiliations

Soon will be listed here.

Abstract

Background: The purpose of this study was to analyze response to palliative low-dose involved-field radiotherapy (LD-IF-RT) (two 2-Gy fractions), explore factors predicting for response, and determine the time course to subsequent treatment.

Patients And Methods: Thirty-three patients with advanced or recurrent indolent non-Hodgkin's lymphoma (NHL) received LD-IF-RT to 43 sites. Response was assessed by physical examination and radiographic studies. Median follow-up for individual sites was 14 months. Fisher's exact test was used to evaluate prognostic factors for response and in-field progression.

Results: Overall response was 95%. Thirty-six sites (84%) had a complete response (CR), five sites (12%) had a partial response, and two sites (5%) had progressive disease. The CR rate of head and neck sites was significantly higher than that of pelvic and/or inguinofemoral sites (95% versus 64%, P = 0.04). The CR rate was significantly higher for sites < or =40 mm than for sites >40 mm (90% versus 56%, P = 0.04). Ten sites (23%) had in-field progression diagnosed at a median of 9 months. Sixteen patients (48%) received systemic treatment at a median of 8 months. Fourteen patients (42%) did not require additional treatment.

Conclusions: LD-IF-RT for selected NHL subtypes has excellent local CR and in-field control rates and may postpone the need for systemic therapy.

Citing Articles

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Personalised therapy in follicular lymphoma - is the dial turning?.

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Low grade, indolent lymphomas of the head and neck: Comparative toxicity of standard versus very low dose radiation therapy.

Chelius M, Chau K, Yang J, Hajj C, Imber B, Yahalom J Hematol Oncol. 2021; 39(3):304-312.

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References

Guadagnolo B, Li S, Neuberg D, Ng A, Hua L, Silver B . Long-term outcome and mortality trends in early-stage, Grade 1-2 follicular lymphoma treated with radiation therapy. Int J Radiat Oncol Biol Phys. 2005; 64(3):928-34. DOI: 10.1016/j.ijrobp.2005.08.010. View

Johannsson J, Specht L, Mejer J, Jensen B . Phase II study of palliative low-dose local radiotherapy in disseminated indolent non-Hodgkin's lymphoma and chronic lymphocytic leukemia. Int J Radiat Oncol Biol Phys. 2002; 54(5):1466-70. DOI: 10.1016/s0360-3016(02)03050-x. View

Montoto S, Davies A, Matthews J, Calaminici M, Norton A, Amess J . Risk and clinical implications of transformation of follicular lymphoma to diffuse large B-cell lymphoma. J Clin Oncol. 2007; 25(17):2426-33. DOI: 10.1200/JCO.2006.09.3260. View

Sawyer E, Timothy A . Low dose palliative radiotherapy in low grade non-Hodgkin's lymphoma. Radiother Oncol. 1997; 42(1):49-51. DOI: 10.1016/s0167-8140(96)01854-3. View

Ganem G, Lambin P, Socie G, Girinsky T, Bosq J, Pico J . Potential role for low dose limited-field radiation therapy (2 x 2 grays) in advanced low-grade non-Hodgkin's lymphomas. Hematol Oncol. 1994; 12(1):1-8. DOI: 10.1002/hon.2900120102. View

Haas R, Poortmans P, de Jong D, Verheij M, van der Hulst M, de Boer J . Effective palliation by low dose local radiotherapy for recurrent and/or chemotherapy refractory non-follicular lymphoma patients. Eur J Cancer. 2005; 41(12):1724-30. DOI: 10.1016/j.ejca.2005.04.033. View

Girinsky T, Koscielny S, Cosset J, Ganem G, Carde P, Monhonval M . A high and sustained response rate in refractory or relapsing low-grade lymphoma masses after low-dose radiation: analysis of predictive parameters of response to treatment. Int J Radiat Oncol Biol Phys. 2001; 51(1):148-55. DOI: 10.1016/s0360-3016(01)01626-1. View

Hoppe R . The non-Hodgkin's lymphomas: pathology, staging, treatment. Curr Probl Cancer. 1987; 11(6):363-447. DOI: 10.1016/s0147-0272(87)80006-5. View

Horning S . Treatment approaches to the low-grade lymphomas. Blood. 1994; 83(4):881-4. View

10.

Tsang R, Gospodarowicz M . Radiation therapy for localized low-grade non-Hodgkin's lymphomas. Hematol Oncol. 2005; 23(1):10-7. DOI: 10.1002/hon.743. View

11.

Haas R, Poortmans P, de Jong D, Aleman B, Dewit L, Verheij M . High response rates and lasting remissions after low-dose involved field radiotherapy in indolent lymphomas. J Clin Oncol. 2003; 21(13):2474-80. DOI: 10.1200/JCO.2003.09.542. View

12.

Vaughan Hudson B, Vaughan Hudson G, MacLennan K, Anderson L, Linch D . Clinical stage 1 non-Hodgkin's lymphoma: long-term follow-up of patients treated by the British National Lymphoma Investigation with radiotherapy alone as initial therapy. Br J Cancer. 1994; 69(6):1088-93. PMC: 1969460. DOI: 10.1038/bjc.1994.213. View

13.

Wilder R, Jones D, Tucker S, Fuller L, Ha C, McLaughlin P . Long-term results with radiotherapy for Stage I-II follicular lymphomas. Int J Radiat Oncol Biol Phys. 2001; 51(5):1219-27. DOI: 10.1016/s0360-3016(01)01747-3. View

14.

Mac Manus M, Hoppe R . Is radiotherapy curative for stage I and II low-grade follicular lymphoma? Results of a long-term follow-up study of patients treated at Stanford University. J Clin Oncol. 1996; 14(4):1282-90. DOI: 10.1200/JCO.1996.14.4.1282. View