Rosenbluth Benjamin D, Yahalom Joachim
Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA.
Int J Radiat Oncol Biol Phys. 2006 Jul 15;65(4):1185-91. doi: 10.1016/j.ijrobp.2006.02.011. Epub 2006 May 6.
Although radiosensitivity of mantle cell lymphoma (MCL) has been demonstrated in vitro, radiotherapy is rarely employed in treatment of MCL. We studied clinical responses of MCL patients treated with involved-field radiation therapy (IFRT) predominantly for local control and/or palliation.
A total of 21 consecutive patients (38 sites) treated with IFRT for MCL were retrospectively analyzed. Median age was 68. Seventeen patients had Stage IV/relapsed disease, 1 had Stage II, and 3 had Stage I disease. Most patients received prior chemotherapy, with an average of two combinations per patient. Mean number of sites treated per patient was two. Mean total dose was 30 Gy.
Mean follow-up was 13 months. Overall local response rate was 100%. Complete response was obtained in 64% of the sites and partial response in 36%. Average time to response was 20 days. Twenty-eight sites had a response before radiation therapy was complete. Of 16 sites associated with pre-IFRT pain or discomfort, 15 exhibited post-IFRT relief. Thirteen sites (34%) exhibited local progression, with a median time to progression of 10 months, and an average response duration of 9 months. Five patients experienced Grade II radiation-related toxicity. No Grade III toxicity was reported. Twelve-month overall survival for patients receiving IFRT was 55%.
Radiotherapy provided effective and lasting local responses in MCL patients and was associated with minimal toxicity. Radiation doses required for most lesions were relatively low and responses were noticed early in the course of treatment. Radiation therapy should be considered early in the course of relapsing, refractory, or localized MCL.
尽管套细胞淋巴瘤（MCL）的放射敏感性已在体外得到证实，但放射治疗很少用于MCL的治疗。我们研究了主要为局部控制和/或缓解而接受累及野放射治疗（IFRT）的MCL患者的临床反应。
回顾性分析了21例连续接受IFRT治疗MCL的患者（38个部位）。中位年龄为68岁。17例患者为IV期/复发疾病，1例为II期，3例为I期疾病。大多数患者接受过先前的化疗，平均每位患者接受两种联合化疗。每位患者平均治疗部位数为两个。平均总剂量为30 Gy。
平均随访时间为13个月。总体局部缓解率为100%。64%的部位获得完全缓解，36%获得部分缓解。平均缓解时间为20天。28个部位在放射治疗完成前出现缓解。在与IFRT前疼痛或不适相关的16个部位中，15个部位在IFRT后疼痛缓解。13个部位（34%）出现局部进展，中位进展时间为10个月，平均缓解持续时间为9个月。5例患者出现II级放射性相关毒性。未报告III级毒性。接受IFRT患者的12个月总生存率为55%。
放射治疗在MCL患者中提供了有效且持久的局部反应，且毒性极小。大多数病变所需的放射剂量相对较低，且在治疗过程中早期即可观察到反应。对于复发、难治性或局限性MCL患者，应在病程早期考虑放射治疗。
