Haque Waqar, Voong K Ranh, Shihadeh Ferial, Arzu Isidora, Pinnix Chelsea, Mazloom Ali, Medeiros L Jeffrey, Romaguera Jorge, Rodriguez Alma, Wang Michael, Allen Pamela, Dabaja Bouthaina
Department of Radiation Oncology, University of Texas Medical Branch, Galveston, TX.
Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, TX.
Clin Lymphoma Myeloma Leuk. 2014 Dec;14(6):474-9. doi: 10.1016/j.clml.2014.07.003. Epub 2014 Jul 15.
Mantle cell lymphoma has an aggressive clinical course and continuous relapse pattern with a median survival of 3 to 7 years. Multiple courses of chemotherapy are the basis of treatment. Radiotherapy is underutilized in this disease. We undertook this study to assess the role of radiation therapy.
A total of 41 consecutive patients with mantle cell lymphoma diagnosed from December, 1999 to January, 2010 who received radiation therapy were reviewed retrospectively. The main endpoint was in-field lymphoma response at each irradiated disease site.
There were 39 evaluable patients (68 symptomatic sites). Sites treated included: nodal stations (n = 31), soft tissue (n = 13), mucosal sites (n = 11), central nervous system (n = 10), gastrointestinal tract (n = 2), and bone (n = 1). Median maximum tumor size at presentation was 3.5 cm (range, 1.3 cm-9.6 cm). The median dose of radiation was 30.6 Gy (range 18-40 Gy). Median follow-up post radiation per site was 12.3 months (range, 0.6-80.9 months). Response to treatment was complete in 47 sites (69.1%), partial in 16 sites (23.5%), and 5 sites (7.4%) had stable disease. In 9 (13.2%) sites local relapse occurred (median 7 months; range 2-21). The mean size of lymphoma at time of RT correlated with relapse, with tumors with local relapse larger than those without a local relapse (P = .005).
Our data add to accumulating evidence that mantle cell lymphoma is a radio-sensitive disease with excellent responses to relatively low radiation doses, even in patients with chemo-refractory disease.
套细胞淋巴瘤具有侵袭性的临床病程和持续复发模式，中位生存期为3至7年。多疗程化疗是治疗的基础。放射治疗在该疾病中的应用不足。我们开展这项研究以评估放射治疗的作用。
回顾性分析了1999年12月至2010年1月期间连续收治的41例接受放射治疗的套细胞淋巴瘤患者。主要终点是每个照射疾病部位的野内淋巴瘤反应。
有39例可评估患者（68个有症状部位）。治疗部位包括：淋巴结区域（n = 31）、软组织（n = 13）、黏膜部位（n = 11）、中枢神经系统（n = 10）、胃肠道（n = 2）和骨骼（n = 1）。就诊时肿瘤最大径的中位数为3.5 cm（范围1.3 cm - 9.6 cm）。放射剂量的中位数为30.6 Gy（范围18 - 40 Gy）。每个部位放射治疗后的中位随访时间为12.3个月（范围0.6 - 80.9个月）。47个部位（69.1%）治疗反应为完全缓解，16个部位（23.5%）为部分缓解，5个部位（7.4%）病情稳定。9个部位（13.2%）发生局部复发（中位时间7个月；范围2 - 21个月）。放疗时淋巴瘤的平均大小与复发相关，局部复发的肿瘤比未发生局部复发的肿瘤大（P = 0.005）。
我们的数据进一步证明，套细胞淋巴瘤是一种对放射敏感的疾病，即使是对化疗难治的患者，对相对低剂量的放射治疗也有良好反应。
