Haas R L M, Poortmans Ph, de Jong D, Aleman B M P, Dewit L G H, Verheij M, Hart A A M, van Oers M H J, van der Hulst M, Baars J W, Bartelink H
Department of Radiotherapy, The Netherlands Cancer Institute, Amsterdam, The Netherlands.
J Clin Oncol. 2003 Jul 1;21(13):2474-80. doi: 10.1200/JCO.2003.09.542.
To study the response rates and duration of response after low-dose (4 Gy) involved field radiotherapy (LD-IF-RT) in patients with recurrent indolent lymphoma.
A total of 109 assessable patients (304 symptomatic sites) were irradiated (53 males and 56 females; median age, 62 years; range, 35 to 93), including 98 patients with follicular lymphoma (43 grade 1 and 55 grade 2), nine extranodal marginal zone lymphomas of mucosa-associated lymphoid tissue-type and two patients with lymphoplasmacytoid lymphoma. Bulky disease (> or =5 cm) was present in 52% of all patients. A median of two prior regimens (range, 0 to 11) preceded LD-IF-RT. The median time since diagnosis was 41 months (range, 2 to 358 months). Time to (local) progression was calculated according to the Kaplan-Meier method. Differences in response rates between treatments within the same patient were compared using the McNemar test.
The overall response rate was 92%; complete response was reached in 67 patients (61%), partial response in 34 patients (31%), stable disease in six patients (6%), and progressive disease in two patients (2%). The median time to progression was 14 months. The median time to local progression was 25 months. The 67 patients with complete response showed a median time to progression of 25 months and a median time to local progression of 42 months. None of the factors studied (age, sex, follicular lymphoma grade, radiotherapy regimen, number of previous regimens and previous history, number of positive sites or largest lymphoma diameter) were found to be related to response rate.
LD-IF-RT is a valuable asset in the management of patients with follicular lymphoma and should be considered in patients with recurrent disease.
研究低剂量（4 Gy）累及野放疗（LD-IF-RT）治疗复发性惰性淋巴瘤患者的缓解率及缓解持续时间。
共109例可评估患者（304个有症状部位）接受了放疗（53例男性和56例女性；中位年龄62岁；范围35至93岁），包括98例滤泡性淋巴瘤患者（43例1级和55例2级）、9例黏膜相关淋巴组织型结外边缘区淋巴瘤患者以及2例淋巴浆细胞样淋巴瘤患者。所有患者中52%存在大包块病变（≥5 cm）。LD-IF-RT之前的中位治疗方案数为2个（范围0至11个）。自诊断以来的中位时间为41个月（范围2至358个月）。根据Kaplan-Meier方法计算至（局部）进展时间。采用McNemar检验比较同一患者不同治疗之间的缓解率差异。
总缓解率为92%；67例患者（61%）达到完全缓解，34例患者（31%）达到部分缓解，6例患者（6%）疾病稳定，2例患者（2%）疾病进展。中位至进展时间为14个月。中位至局部进展时间为25个月。67例完全缓解患者的中位至进展时间为25个月，中位至局部进展时间为42个月。未发现所研究的因素（年龄、性别、滤泡性淋巴瘤分级、放疗方案、既往治疗方案数及既往病史、阳性部位数或最大淋巴瘤直径）与缓解率相关。
LD-IF-RT是滤泡性淋巴瘤患者管理中的一项重要治疗手段，复发患者应考虑采用。
