Jeong Jae Uk, Lee Hyo Chun, Song Jin Ho, Eom Keun Yong, Kim Jin Hee, Kwak Yoo Kang, Kim Woo Chul, Lee Sun Young, Choi Jin Hwa, Lee Kang Kyu, Lee Jong Hoon
Department of Radiation Oncology, Chonnam National University School of Medicine, Gwangju, Korea.
Department of Radiation Oncology, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea.
Cancer Res Treat. 2025 Apr;57(2):570-579. doi: 10.4143/crt.2024.651. Epub 2024 Oct 4.
This study aimed to evaluate long-term treatment outcomes in patients with localized gastric mucosa-associated lymphoid tissue (MALT) lymphoma treated with radiotherapy (RT).
A total of 229 patients who received RT in 10 tertiary hospitals between 2010 and 2019 were included in this multicenter analysis. Response after RT was based on esophagogastroduodenoscopy after RT. Locoregional relapse-free survival (LRFS) and disease-free survival (DFS), and overall survival (OS) were evaluated.
After a median follow-up time of 93.2 months, 5-year LRFS, DFS, and OS rates were 92.8%, 90.4%, and 96.1%, respectively. LRFS, DFS, and OS rates at 10 years were 90.3%, 87.7%, and 92.8%, respectively. Of 229 patients, 228 patients (99.6%) achieved complete remission after RT. Five-year LRFS was significantly lower in patients with stage IIE than in those with stage IE (77.4% vs. 94.2%, p=0.047). Patients with age ≥ 60 had significantly lower LRFS than patients with age < 60 (89.3% vs. 95.1%, p=0.003). In the multivariate analysis, old age (≥ 60 years) was a poor prognostic factor for LRFS (hazard ratio, 3.72; confidence interval, 1.38 to 10.03; p=0.009). Grade 2 or higher gastritis was reported in 69 patients (30.1%). Secondary malignancies including gastric adenocarcinoma, malignant lymphoma, lung cancer, breast cancer, and prostate cancer were observed in 11 patients (4.8%) after RT.
Patients treated with RT for localized gastric MALT lymphoma showed favorable 10-year outcomes. Radiation therapy is an effective treatment without an increased risk of secondary cancer. The toxicity for RT to the stomach is not high.
本研究旨在评估接受放射治疗（RT）的局限性胃黏膜相关淋巴组织（MALT）淋巴瘤患者的长期治疗效果。
本多中心分析纳入了2010年至2019年间在10家三级医院接受RT治疗的229例患者。RT后的反应基于RT后的食管胃十二指肠镜检查。评估局部区域无复发生存期（LRFS）、无病生存期（DFS）和总生存期（OS）。
中位随访时间为93.个月后，5年LRFS、DFS和OS率分别为92.8%、90.4%和96.1%。LRFS、DFS和OS率在10年时分别为90.3%、87.7%和92.8%。在229例患者中，228例（99.6%）在RT后实现完全缓解。IIE期患者的5年LRFS显著低于IE期患者（77.4%对94.2%，p=0.047）。年龄≥60岁的患者LRFS显著低于年龄<60岁的患者（89.3%对95.1%，p=0.003）。在多变量分析中，老年（≥60岁）是LRFS的不良预后因素（风险比，3.72；置信区间，1.38至10.03；p=0.009）。69例患者（30.1%）报告有2级或更高等级的胃炎。RT后11例患者（4.8%）观察到包括胃腺癌、恶性淋巴瘤、肺癌、乳腺癌和前列腺癌在内的继发性恶性肿瘤。
接受RT治疗的局限性胃MALT淋巴瘤患者显示出良好的10年治疗效果。放射治疗是一种有效的治疗方法，不会增加继发性癌症的风险。RT对胃的毒性不高。
