Blood Res 2020; 55(4):
Published online December 31, 2020
https://doi.org/10.5045/br.2020.2020174
© The Korean Society of Hematology
Correspondence to : Shigenobu Watanabe, M.D., Ph.D.
Department of Radiation Oncology, Yokohama City University Medical Center, 4-57 Urafune-cho, Minami-ku, Yokohama 232-0024, Japan
E-mail: kaninabe_30v@yahoo.co.jp
Background
Radiotherapy is often used for treating patients with gastric mucosa-associated lymphoid tissue (MALT) lymphomas who fail to respond to
Methods
The study included 34 patients with stage I EA gastrointestinal MALT lymphoma according to the Ann Arbor classification who underwent definitive radiotherapy. The primary site was the rectum in 3, the duodenum in 1, and the stomach in 30 patients. The radiotherapy dose was 1.5-2.0 Gy (median, 1.5 Gy) and the total dose was 30-40 Gy (median, 30 Gy). The clinical target volume (CTV) was defined as the volume of the entire organ with the lymphoma. Adjacent lymph node areas were not routinely included in the CTV.
Results
Complete response (CR) was achieved in all patients. There were no local recurrences, and two cases of recurrence were observed at other sites. The 5-year overall survival rates for non-gastric and gastric MALT lymphomas were 100% and 94.7%, respectively, and the 5-year disease-free survival rates were 100% and 95.7%, respectively. None of the patients died of the current illness.
Conclusion
Radiotherapy for non-gastric intestinal MALT lymphoma is expected to result in good local control and long-term survival, similar to that for gastric MALT lymphoma.
Keywords Non-gastric intestinal MALT lymphoma, Gastric MALT lymphoma, Radiotherapy, Survival, Local control
Blood Res 2020; 55(4): 200-205
Published online December 31, 2020 https://doi.org/10.5045/br.2020.2020174
Copyright © The Korean Society of Hematology.
Shigenobu Watanabe1, Ichiro Ogino1, Masaharu Hata2
1Department of Radiation Oncology, Yokohama City University Medical Center, 2Department of Radiation Oncology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
Correspondence to:Shigenobu Watanabe, M.D., Ph.D.
Department of Radiation Oncology, Yokohama City University Medical Center, 4-57 Urafune-cho, Minami-ku, Yokohama 232-0024, Japan
E-mail: kaninabe_30v@yahoo.co.jp
Background
Radiotherapy is often used for treating patients with gastric mucosa-associated lymphoid tissue (MALT) lymphomas who fail to respond to
Methods
The study included 34 patients with stage I EA gastrointestinal MALT lymphoma according to the Ann Arbor classification who underwent definitive radiotherapy. The primary site was the rectum in 3, the duodenum in 1, and the stomach in 30 patients. The radiotherapy dose was 1.5-2.0 Gy (median, 1.5 Gy) and the total dose was 30-40 Gy (median, 30 Gy). The clinical target volume (CTV) was defined as the volume of the entire organ with the lymphoma. Adjacent lymph node areas were not routinely included in the CTV.
Results
Complete response (CR) was achieved in all patients. There were no local recurrences, and two cases of recurrence were observed at other sites. The 5-year overall survival rates for non-gastric and gastric MALT lymphomas were 100% and 94.7%, respectively, and the 5-year disease-free survival rates were 100% and 95.7%, respectively. None of the patients died of the current illness.
Conclusion
Radiotherapy for non-gastric intestinal MALT lymphoma is expected to result in good local control and long-term survival, similar to that for gastric MALT lymphoma.
Keywords: Non-gastric intestinal MALT lymphoma, Gastric MALT lymphoma, Radiotherapy, Survival, Local control
Table 1 . Patient characteristics..
Non-gastric MALT lymphoma, N=4 (%) | Gastric MALT lymphoma, N=30 (%) | |
---|---|---|
Sex | ||
Male | 2 (50) | 14 (46.7) |
Female | 2 (50) | 16 (53.3) |
Age (yr) | ||
Mean (range) | 71 (38–89) | 66 (31–82) |
Abnormal uptake on FDG-PET | ||
+ | 3 (75) | 10 (33.3) |
- | 1 (25) | 10 (33.3) |
Not enforced | 0 (0) | 10 (33.3) |
SUVmax | ||
Mean (range) | 5.3 (3.7–17.1) | 6.0 (3.0–16.7) |
+ | 0 (0) | 14 (46.7) |
- | 4 (100) | 16 (53.3) |
Total treatment period (days) | ||
Mean (range) | 28.5 (21–29) | 29 (26–35) |
Prescription dose (Gy) | ||
Mean (range) | 30 (30–30) | 30 (30–40) |
Fractionation dose (Gy) | ||
Mean (range) | 1.5 (1.5–2.0) | 1.5 (1.5–2.0) |
Hemoglobin (g/dL) | ||
Mean (range) | 11.3 (10.2–15.4) | 13.2 (9.3–16.3) |
Platelet (×104/mL) | ||
Mean (range) | 23.6 (20.8–26.3) | 23.0 (12.6–43.2) |
Serum albumin (g/dL) | ||
Mean (range) | 4.6 (3.7–5.5) | 4.5 (3.6–5.1) |
Soluble IL2 receptor (U/mL) | ||
Mean (range) | 433.4 (200–597.5) | 316.2 (200–713.5) |
Immunoglobulin G (mg/dL) | ||
Mean (range) | 1,333 (1,108–2,504) | 1,380 (847–2,138) |
Immunoglobulin A (mg/dL) | ||
Mean (range) | 310 (157–367) | 258 (107–396) |
Immunoglobulin M (mg/dL) | ||
Mean (range) | 84 (20–99) | 76 (38–275) |
b2-microglobulin (mg/L) | ||
Mean (range) | 1.87 (1.19–2.66) | 1.45 (1.04–4.32) |
Abbreviations: FDG-PET, 18F-fluorodeoxy glucose-positron emission tomography;
Table 2 . Details of cases with recurrence..
No. | Age/sex | Primary site | Dose/fraction | Fraction | Total dose | Adjuvant chemotherapy | Treatment effect | Local recurrence | Distant recurrence | Period until recurrence (mo.) | Recurrence site | Recurrence Pathology | Out come | Observation period | Cause of death | |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
1 | 65/F | Stomach | 1.5 | 20 | 30 | + | - | CR | - | + | 67 | Lung | MALT | Alive | 136 | - |
2 | 72/M | Stomach | 1.5 | 20 | 30 | - | - | CR | - | + | 33 | Rectum and cecum | DLBCL | Dead | 75 | Respiratory failure |
Abbreviations: CR, complete response; F, female;
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