Department of Radiation Oncology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
Int J Radiat Oncol Biol Phys. 2011 Nov 1;81(3):e1-6. doi: 10.1016/j.ijrobp.2010.12.062. Epub 2011 Mar 11.
To assess the response rate, duration of response, and overall survival after low-dose involved-field radiotherapy in patients with recurrent low-grade lymphoma or chronic lymphocytic leukemia (CLL).
Forty-three (24 women, 19 men) consecutive patients with indolent lymphoma or CLL were treated with a total dose of 4 Gy (2 × 2 Gy) using 6- 18-MV photons. The median age was 73 years (range, 39-88). Radiotherapy was given either after (n = 32; 75%) or before (n = 11; 25%) chemotherapy. The median time from diagnosis was 48 months (range, 1-249). The median follow-up period was 20 months (range, 1-56).
The overall response rate was 90%. Twelve patients (28%) had a complete response, 15 (35%) had a partial response, 11 (26%) had stable disease, and 5 (11%) had progressive disease. The median overall survival for patients with a positive response (complete response/partial response/stable disease) was 41 months; for patients with progressive disease it was 6 months (p = 0.001). The median time to in-field progression was 21 months (range, 0-24), and the median time to out-field progression was 8 months (range, 0-40). The 3-year in-field control was 92% in patients with complete response (median was not reached). The median time to in-field progression was 9 months (range, 0.5-24) in patients with partial response and 6 months (range, 0.6-6) in those with stable disease (p < 0.05). Younger age, positive response to radiotherapy, and no previous chemotherapy were the best factors influencing the outcome.
Low-dose involved-field radiotherapy is an effective treatment in the management of patients with recurrent low-grade lymphoma or CLL.
评估复发的低度恶性淋巴瘤或慢性淋巴细胞白血病（CLL）患者接受低剂量累及野放疗后的反应率、反应持续时间和总生存期。
43 例（24 例女性，19 例男性）连续的惰性淋巴瘤或 CLL 患者接受了总剂量为 4 Gy（2×2 Gy）的 6-18-MV 光子治疗。中位年龄为 73 岁（范围，39-88 岁）。放疗分别在化疗后（n=32；75%）或化疗前（n=11；25%）进行。从诊断到放疗的中位时间为 48 个月（范围，1-249 个月）。中位随访时间为 20 个月（范围，1-56 个月）。
总缓解率为 90%。12 例（28%）患者达到完全缓解，15 例（35%）患者达到部分缓解，11 例（26%）患者病情稳定，5 例（11%）患者病情进展。阳性反应（完全缓解/部分缓解/稳定疾病）患者的中位总生存期为 41 个月；疾病进展患者的中位总生存期为 6 个月（p=0.001）。靶区内进展的中位时间为 21 个月（范围，0-24 个月），靶区外进展的中位时间为 8 个月（范围，0-40 个月）。完全缓解患者的 3 年靶区内控制率为 92%（中位无进展期未达到）。部分缓解患者的靶区内进展中位时间为 9 个月（范围，0.5-24 个月），病情稳定患者的靶区内进展中位时间为 6 个月（范围，0.6-6 个月）（p<0.05）。年龄较小、对放疗有阳性反应以及无先前化疗是影响结果的最佳因素。
低剂量累及野放疗是治疗复发性低度恶性淋巴瘤或 CLL 的有效方法。
