Nam Heerim, Lim Do Hoon, Kim Jae J, Lee Jun Haeng, Min Byung-Hoon, Lee Hyuk
Department of Radiation Oncology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 03181, Korea.
Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea.
Cancers (Basel). 2021 Jan 6;13(2):169. doi: 10.3390/cancers13020169.
This study aimed to evaluate the clinical outcomes of radiation therapy (RT) for stage I gastric mucosa-associated lymphoid tissue (MALT) lymphoma and find predictive factors for relapse after RT. This retrospective study included 145 patients without a prior history of treatment, except eradication therapy, who were irradiated for stage I gastric MALT lymphoma. The gastric body was the most commonly involved location of the dominant lesion (66.9%), and infection at first diagnosis was detected in 61 (42.1%) patients. The median RT dose was 30 Gy (range, 24-40). Seven patients had an autoimmune disease. All patients except one achieved a complete remission at post-treatment endoscopic biopsy after a median of 2 months (range, 1-36). During the median follow-up at 51 months (range, 2-146), 11 patients experienced relapses: in the stomach ( = 5), in a distant site ( = 4), and in both ( = 2). The five-year overall, local relapse-free, distant relapse-free, and relapse-free survival (RFS) rates were 98.6%, 94.0%, 97.1%, and 92.3%, respectively. In multivariate analysis for RFS, the location of MALT lymphoma other than in the gastric body was significantly associated with an increased risk of relapse (hazard ratio 5.85 (95% CI 1.49-22.9), = 0.011). RT results in favorable clinical outcomes in patients with stage I gastric MALT lymphoma. Tumor location could be a predictive factor for relapse after RT.
本研究旨在评估Ⅰ期胃黏膜相关淋巴组织(MALT)淋巴瘤放射治疗(RT)的临床疗效,并寻找RT后复发的预测因素。这项回顾性研究纳入了145例除根除治疗外无既往治疗史的Ⅰ期胃MALT淋巴瘤患者,这些患者接受了放疗。胃体是主要病变最常累及的部位(66.9%),61例(42.1%)患者在首次诊断时检测到感染。RT的中位剂量为30 Gy(范围24 - 40)。7例患者患有自身免疫性疾病。除1例患者外,所有患者在中位2个月(范围1 - 36)的治疗后内镜活检时均实现完全缓解。在中位51个月(范围2 - 146)的随访期间,11例患者复发:胃部复发(n = 5)、远处部位复发(n = 4)以及两者均复发(n = 2)。五年总生存率、局部无复发生存率、远处无复发生存率和无复发生存率(RFS)分别为98.6%、94.0%、97.1%和92.3%。在RFS的多因素分析中,胃体以外的MALT淋巴瘤部位与复发风险增加显著相关(风险比5.85(95%CI 1.49 - 22.9),P = 0.011)。RT对Ⅰ期胃MALT淋巴瘤患者可产生良好的临床疗效。肿瘤部位可能是RT后复发的预测因素。