Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Cancer Res Treat. 2019 Apr;51(2):547-555. doi: 10.4143/crt.2018.190. Epub 2018 Jul 10.
Duodenal-type follicular lymphoma (FL) is a rare variant of FL. There is still no consensus on the initial treatment, and clinical features including endoscopic findings are not familiar to most physicians. The objective of this study was to evaluate the outcome of patients who were initially treated with radiation therapy for duodenal-type FL.
We retrospectively analyzed 20 patients who were consecutively diagnosed with duodenaltype FL between 2008 and 2017. All patients received radiation therapywith curative intent.
The median age of the patients was 52 years (range, 26 to 66 years), and females were predominant. Most patients (n=18, 90%) had stage I disease, and were diagnosed by a regular health examination in an asymptomatic state. The histological grade was one in 19 patients (95%), and the endoscopic findings were diffuse nodular (n=8), whitish granular (n=8), and mixed pattern (n=4). Radiation therapy was delivered to 17 patients with 24 Gy in 12 fractions, and to three patients with 30.6-36 Gy in 18 fractions. All patients were evaluated with endoscopy for response to radiation therapy, and complete response was achieved in 19 patients (95%). At the time of analysis, all patients survived without any evidence of late toxicities related with radiation therapy.
Taken together, radiation therapy alone could be effective in controlling duodenal lesion. A further study with longer follow-up duration is warranted to confirm our findings.
十二指肠型滤泡淋巴瘤(FL)是一种罕见的 FL 亚型。目前对于初始治疗仍无共识,大多数医生对其临床特征,包括内镜表现并不熟悉。本研究旨在评估以放射治疗为初始治疗的十二指肠型 FL 患者的结局。
我们回顾性分析了 2008 年至 2017 年间连续诊断为十二指肠型 FL 的 20 例患者。所有患者均接受了以治愈为目的的放射治疗。
患者的中位年龄为 52 岁(范围 26-66 岁),女性居多。大多数患者(n=18,90%)为Ⅰ期疾病,且均在无症状状态下通过常规健康检查发现。19 例患者(95%)的组织学分级为 1 级,内镜表现为弥漫性结节状(n=8)、乳白色颗粒状(n=8)和混合性(n=4)。17 例患者接受了 24 Gy 分 12 次照射,3 例患者接受了 30.6-36 Gy 分 18 次照射。所有患者均接受内镜评估放射治疗的反应,19 例患者(95%)达到完全缓解。在分析时,所有患者均存活且无任何与放射治疗相关的晚期毒性证据。
单独放疗可能对控制十二指肠病变有效。需要进一步进行随访时间更长的研究以证实我们的发现。