P0130 Combined modality therapy for patients with gastric non-hodgkin lymphoma: Updated long-term results

2014 ◽  
Vol 50 ◽  
pp. e46
Author(s):  
S.V. Golub ◽  
G.A. Panshin ◽  
V.M. Sotnikov ◽  
V.A. Solodkiy
Keyword(s):  
Hodgkin Lymphoma ◽  
Combined Modality Therapy ◽  
Long Term Results ◽  
Non Hodgkin Lymphoma ◽  
Combined Modality

Long-Term Results of Combined-Modality Therapy in Resectable Non–Small-Cell Lung Cancer

2002 ◽  
Vol 20 (8) ◽  
pp. 1989-1995 ◽  
Author(s):  
Jocelyne Martin ◽  
Robert J. Ginsberg ◽  
Ennapadam S. Venkatraman ◽  
Manjit S. Bains ◽  
Robert J. Downey ◽  
...  
Keyword(s):  
Combined Modality Therapy ◽  
Pathologic Complete Response ◽  
Complete Response ◽  
Complete Resection ◽  
Small Cell ◽  
Long Term Results ◽  
Small Cell Lung ◽  
Combined Modality

PURPOSE: Assessment of long-term results of combined-modality therapy for resectable non–small-cell lung cancer is hampered by insufficient follow-up and small patient numbers. To evaluate this, we reviewed our collective experience. PATIENTS AND METHODS: This study was a retrospective chart review recording demographics, tumor stage, treatment, and outcome of consecutive patients undergoing surgery. Survival was analyzed by Kaplan-Meier, and prognostic factors were analyzed by log-rank and Cox regression. RESULTS: From January 1993 to December 1999, 470 patients were treated, with follow-up in 446: 27 stage I, 55 stage II, 316 stage III, 43 stage IV (solitary M1), and five uncertain. Chemotherapy was mitomycin/vinblastine/cisplatin (174 patients [39.0%]), carboplatin/paclitaxel (148 [33.2%]), and other combination (124 [27.8%]); 75 patients (16.8%) received induction radiation. Resection was complete in 77.4%, incomplete in 8.3%, attempted but with gross residual disease afterward in 1.8%, and not performed in 12.6%. Pathologic complete response occurred in 20 patients (4.5%). With median follow-up of 31.0 months for patients still alive, median and 3-year survival for pathologic stages 0, I, II, III, and IV were more than 90 months, 73%; 42 months, 52%; 23 months, 35%; 16 months, 28%; and 16 months, 23% (P < .001). In a multivariate analysis, age, complete resection, pathologic stage, and pneumonectomy, but not induction regimen, significantly influenced survival. CONCLUSION: Although pathologic complete response outside the protocol setting is low, survival of this large patient cohort is comparable to that of patients in published combined-modality trials. Survival is significantly influenced by patient age, complete resection, pathologic stage, and pneumonectomy. These results can help guide standard clinical practice and emphasize the need for novel induction regimens.

Risk Factors For Radiation Pneumonitis In Patients With Lymphoma Treated With Chemotherapy and Photon Or Proton Radiotherapy

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 5101-5101
Author(s):  
Anna Mesina ◽  
Surbhi Grover ◽  
Carmen Mesina ◽  
Sunita D. Nasta ◽  
Jakub Svoboda ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hodgkin Lymphoma ◽  
Radiation Pneumonitis ◽  
Combined Modality Therapy ◽  
Proton Radiotherapy ◽  
Lung Dose ◽  
Non Hodgkin Lymphoma ◽  
Combined Modality ◽  
Dose Volume ◽  
Higher Doses

Abstract Introduction As volume-based radiotherapy planning has become a more standard part of combined modality therapy for lymphomas, dose-volume based constraints for organs-at-risk are needed for treatment planning. Conformal techniques such as intensity modulated radiation therapy and proton radiotherapy may achieve lower doses to certain organs like the heart, but may result in higher doses to other tissues like the lungs and breasts. We sought to define the dosimetric risk factors that are associated with development of radiation pneumonitis (RP). Methods This is a single-institution retrospective analysis of patients with thoracic lymphomas treated with combined modality therapy between 1999 and 2013 who had at least 4 months of follow-up after radiotherapy. Univariate analyses (UVA) were performed using Fisher exact and Wilcoxon rank-sum tests. Results Of the 89 patients analyzed, 13 (14.6%) were diagnosed with RP (at least Grade 1, Common Toxicity Criteria v4.0). Patients were predominantly female (62%) and never smoked (67%). Diagnoses were grouped as Hodgkin lymphoma (62.9%) or non-Hodgkin lymphoma (37.1%), and 18.5% were also treated with autologous stem cell transplants. UVA showed that RP was more commonly associated with a diagnosis of non-Hodgkin lymphoma (38%) than Hodgkin lymphoma (8%), despite exposure to bleomycin in the majority of patients with Hodgkin lymphoma. Higher lung doses were significantly associated with RP using multiple lung dose-volume parameters: mean lung dose (12.3 vs. 16.7 Gy, p=0.002), volume of lung receiving 20 Gy (27.3% vs. 39.1%, p=0.0009), and volume of lung receiving 5 Gy (51% vs. 66.8%, p=0.004). The majority (67%) of patients who developed RP had mean lung doses of over 15 Gy, whereas only 24% of those who did not develop RP had mean lung doses above 15 Gy, see Figure. Heart dosimetric parameters were also significantly associated with RP, including mean heart dose (13.3 vs. 21.5 Gy, p=0.004), volume of heart receiving 20 Gy (25.4% vs. 48.3%, p=0.003), and volume of heart receiving 5 Gy (57.6% vs. 81.1%, p=0.04). There were not enough events to determine if heart and lung parameters were independently associated with RP, but they were strongly correlated (R=0.75). Gender, smoking history, and autologous transplant were not significantly associated with RP. None of the 13 patients treated with proton radiotherapy developed RP. In general, patients treated with proton radiotherapy had lower mean heart doses (9.4 vs. 15.4 Gy) and mean lung doses (9.6 Gy vs. 13.5 Gy). Conclusions Higher doses to lung and heart are associated with increased risk of RP, and doses to these critical structures should be considered carefully during volume-based consolidative radiotherapy using advanced techniques. Disclosures: No relevant conflicts of interest to declare.

Long-term results with the adapted LMB 96 protocol in children with B-cell non Hodgkin lymphoma treated in Iraq: comparison in two subsequent cohorts of patients

2019 ◽  
Vol 60 (5) ◽  
pp. 1224-1233 ◽  
Author(s):  
Maria Luisa Moleti ◽  
Mazin Faisal Al-Jadiry ◽  
Wafa Ablahad Shateh ◽  
Amir Fadhil Al-Darraji ◽  
Sara Mohamed ◽  
...  
Keyword(s):  
B Cell ◽  
Hodgkin Lymphoma ◽  
Long Term Results ◽  
Non Hodgkin Lymphoma

Combined-Modality Therapy Versus Radiotherapy Alone for Treatment of Early-Stage Hodgkin's Disease: Cure Balanced Against Complications

2006 ◽  
Vol 24 (4) ◽  
pp. 605-611 ◽  
Author(s):  
Bridget F. Koontz ◽  
John P. Kirkpatrick ◽  
Robert W. Clough ◽  
Robert G. Prosnitz ◽  
Jon P. Gockerman ◽  
...  
Keyword(s):  
Hodgkin's Disease ◽  
Early Stage ◽  
Hodgkin’S Disease ◽  
Combined Modality Therapy ◽  
Long Term Results ◽  
Cardiac Complications ◽  
Second Malignancies ◽  
Combined Modality ◽  
Radiotherapy Alone

Purpose The treatment of early-stage Hodgkin's disease (HD) has evolved from radiotherapy alone (RT) to combined-modality therapy (CMT) because of concerns about late adverse effects from high-dose subtotal nodal irradiation (STNI). However, there is little information regarding the long-term results of CMT programs that substantially reduce the dose and extent of radiation. In addition, lowering the total radiation dose may reduce the complication rate without compromising cure. This retrospective study compares the long-term results of STNI with CMT using modestly reduced RT dose in the treatment of early-stage HD. Patients and Methods Between 1982 and 2002, 111 patients with stage IA and IIA HD were treated definitively with RT (mean dose, 37.9 Gy); 70 patients were treated with CMT with low-dose involved-field radiotherapy (LDIFRT; mean dose, 25.5 Gy). Median follow-up was 11.7 years for RT patients and 8.1 years for the CMT group. Results There was a trend toward improved 20-year overall survival with CMT (83% v 70%; P = .405). No second cancers were observed in the CMT group; in the RT group the actuarial frequency of a second cancer was 16% at 20 years. There was no difference in the frequency of cardiac complications (9% v 6%, RT v CMT). Conclusion In this retrospective review, CMT with LDIFRT was effective in curing early-stage HD and was not associated with an increase in second malignancies. For RT alone, a moderate dose seemed to reduce cardiac complications but did not lessen second malignancies compared with higher doses used historically.

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