Palliation by Low-Dose Local Radiation Therapy for Indolent Non-Hodgkin Lymphoma

详细信息    查看全文

• 作者：Elisa K. Chan M.D.^&lowast ; ; Sharon Fung M.Sc.^&dagger ; ; Mary Gospodarowicz M.D. ; F.R.C.P.C.^&lowast ; ; David Hodgson M.D. ; M.P.H. ; F.R.C.P.C.^&lowast ; ; Woodrow Wells M.D. ; F.R.C.P.C.^&lowast ; ; Alexander Sun M.D. ; F.R.C.P.C.^&lowast ; ; Melania Pintile M.Sc.^&dagger ; ;   ; ^&Dagger ; ; Richard W. Tsang M.D. ; F.R.C.P.C.^&lowast ; ;   ; ^{richard.tsang@rmp.uhn.on.ca}
• 刊名：International Journal of Radiation Oncology*Biology*Physics
• 出版年：2011
• 出版时间：1 December 2011
• 年：2011
• 卷：81
• 期：5
• 页码：e781-e786
• 全文大小：149 K

文摘

Purpose

The purpose of this study was to assess the efficacy of a 2 ¡Á 2 Gy (total dose, 4 Gy) palliative radiation therapy (RT) regimen for treating patients with indolent non-Hodgkin lymphoma (NHL) in terms of response rate, response duration, and symptom relief.

Methods and Materials

A retrospective chart review was conducted. Between 2003 and 2007, 54 patients with NHL were treated to 85 anatomical sites with a 2 ¡Á 2 Gy palliative regimen. Local response was assessed by clinical and/or radiographic data. Symptoms before and after treatment for each site treated were obtained from clinical notes in patient medical records. Median follow-up time was 1.3 years.

Results

For the 54 patients, the median age at time of treatment was 71.1 years old, and 57 % of them were male. Of the 85 disease sites treated, 56 % of sites had indolent histology, 28 % of sites were diagnosed with chronic lymphocytic leukemia (CLL), 13 % of sites had aggressive histology, and 2 % of sites were shown to have other histology. Overall response rate (ORR) was 81 % (49 % complete response [CR], 32 % partial response [PR]). The 2-year rate for freedom from local progression was 50 % (95 % CI, 37 % ?1 % ). The ORR for follicular lymphoma, Mucosa associated lymphoid tissue (MALT), and marginal zone lymphoma (MZL) histology was 88 % , compared with a 59 % rate for CLL histology (p = 0.005). While the ORR was similar for tumors of different sizes, the CR rate for patients with tumors <5 cm tended to be higher than those with tumors >10 cm (CR rate of 57 % vs. 27 % , respectively; p = 0.06). For the 48 sites with clearly documented symptoms at pretreatment, 92 % of sites improved after low-dose RT.

Conclusions

Short-course low-dose palliative radiotherapy (2 ¡Á 2 Gy) is an effective treatment that results in high response rates for indolent non-Hodgkin lymphoma. This treatment regimen provides effective symptomatic relief for tumor bulk of all sizes.