Elsevier

Radiotherapy and Oncology

Volume 90, Issue 2, February 2009, Pages 231-235
Radiotherapy and Oncology

MALT lymphoma
Favorable outcomes of radiotherapy for early-stage mucosa-associated lymphoid tissue lymphoma

https://doi.org/10.1016/j.radonc.2008.12.004Get rights and content

Abstract

Purpose

The aim of this study was to evaluate the efficacy of radiation therapy (RT) for early-stage mucosa-associated lymphoid tissue (MALT) lymphoma.

Materials and methods

Patients with stage ΙE (n = 48) and stage ПE (n = 2) MALT lymphoma treated with RT were reviewed. The primary tumor originated in the stomach in 20 patients, in the orbit in 9 patients, in the conjunctiva or eyelid and the parotid glands in 6 patients each, and 9 patients in the others. The median total RT dose was 32 Gy (range, 25.6–50 Gy). The median follow-up time was 50 months.

Results

Although disease did not recur in the RT field in any patient regardless of the total dose, disease recurred outside the RT field in the seven patients. As all recurrences were localized, salvage RT was performed for each recurrence and achieved complete response without recurrence in the field. The 5-year overall survival, local control, and progression-free survival rates were 96.6%, 100%, and 82.2%, respectively.

Conclusions

A total dose of 25–30 Gy is appropriate for local control of MALT lymphoma. RT is also an effective salvage therapy in cases of localized recurrence.

Section snippets

Patient characteristics

Patients with early-stage MALT lymphoma treated with RT from 1988 to May 2008 at Aichi Cancer Center Hospital were reviewed. Patients with transformed MALT lymphoma or primary nodal marginal zone B-cell lymphoma, MALT type, were excluded. The pathologic diagnoses were based on the examination of the hematoxylin and eosin-stained biopsy specimens and supported by immunohistochemical analysis. Immunologic phenotyping with paraffin sections was performed for κ and λ light chain restriction, CD20+,

Response and survival

At the time of evaluation, 49 of 50 patients had achieved CR, which resulted in a 98% CR rate (95% confidence interval [CI], 93.9–100%). The remaining one patient, who had conjunctiva MALT lymphoma, achieved partial response (PR) 6 months after RT; however, this patient has shown no recurrence during a follow-up period of 92 months. Although no patients had disease recurrence in the RT field, seven patients had experienced recurrence outside the RT field. Thus, the 5-year LC rate was 100%. The

Discussion

This study reports on the treatment outcomes of patients with early-stage MALT lymphoma treated with RT. Most patients underwent RT alone as a component of their initial therapy except for H. pylori eradication therapy for gastric MALT lymphoma. The most common sites of involvement were the stomach, orbit, conjunctiva/eyelid, and parotid gland. In this study RT was highly effective and achieved a CR rate of 98% and a 5-year local control rate of 100% in cases of early-stage MALT lymphoma. These

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