Low-Dose Involved-Field Radiation in the Treatment of Non-Hodgkin Lymphoma: Predictors of Response and Treatment Failure

2013 ◽  
Vol 86 (1) ◽  
pp. 121-127 ◽  
Author(s):  
Andrea L. Russo ◽  
Yu-Hui Chen ◽  
Neil E. Martin ◽  
Anant Vinjamoori ◽  
Sarah K. Luthy ◽  
...  
Keyword(s):  
Treatment Failure ◽  
Hodgkin Lymphoma ◽  
Low Dose ◽  
Non Hodgkin Lymphoma ◽  
Predictors Of Response ◽  
Field Radiation ◽  
Involved Field

Local Progression after Low-dose Involved-field Radiation for Non-Hodgkin Lymphoma

2009 ◽  
Vol 75 (3) ◽  
pp. S481 ◽  
Author(s):  
N.E. Martin ◽  
A.K. Ng ◽  
S.K. Luthy ◽  
B.T. Webber ◽  
A.S. Freedman ◽  
...  
Keyword(s):  
Hodgkin Lymphoma ◽  
Low Dose ◽  
Non Hodgkin Lymphoma ◽  
Local Progression ◽  
Field Radiation ◽  
Involved Field

Involved Field Radiation Therapy Following Autologous Stem Cell Rescue for Hodgkin and Non-Hodgkin Lymphoma - Is It Efficacious?.

Blood ◽  
2006 ◽  
Vol 108 (11) ◽  
pp. 3676-3676
Author(s):  
Tithi Biswas ◽  
Sughosh Dhakal ◽  
Sheema Chawla ◽  
Nikhil Uppal ◽  
Sarada Uppuliri ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Stem Cell ◽  
Hodgkin Lymphoma ◽  
P Value ◽  
Stem Cell Rescue ◽  
Non Hodgkin Lymphoma ◽  
Field Radiation ◽  
Involved Field ◽  
Disease Free

Abstract Introduction: Patients with recurrent or refractory Hodgkin (HL) and non-Hodgkin lymphoma (NHL) treated with high dose chemotherapy and autologous stem-cell rescue (ASCR) commonly relapse (post-ASCR) (70–90%) in sites of previous disease. Although adjuvant involved field radiation therapy (IFRT) to sites of previous recurrence might be expected to enhance local control, translation of this into improved disease-free (DFS) or overall survival (OS) is controversial. We sought to evaluate IFRT following ASCR in terms of patterns of recurrence, OS and DFS. Methods and Materials: All 281 patients with recurrent or refractory HL and NHL who underwent ASCR between 5/92 and 7/03 were analyzed. Disease stratification at the time of transplant included HL, 24%, aggressive NHL (ANHL) 62%, and indolent NHL (INHL) 14%. Most, 46% underwent ASCR after 1st relapse, 18% after 2nd relapse, 4% after 3rd relapse and 26% had refractory disease at ASCR. IFRT was administered to 129 patients (46%). Physician and patient choice determined which patients received IFRT. Dose ranged from 20–36 Gy depending on response to salvage therapy before ASCR and the presence of visible imaging abnormalities following ASCR. For end point analysis 39 patients (14%) including 11 HL, 23 ANHL, and 5 INHL had insufficient data and were excluded. Results: Mean follow-up was 3 years (.3 – 12). The median age at ASCR was 45 years (8 – 73). Male to female ratio was 1.3:1. Thirty five percent of patients had prior RT. On univariate analysis, OS and DFS following IFRT for ANHL was superior (or approached this statistically) at 5 years. For HL, improved OS approached significance, whereas DFS did not despite an apparent benefit by disease-free percentages. IFRT appears to be disadvantageous in INHL, but patient numbers were very small. OS and DFS at 5 years are in the table. Survival Table 5-year OS (%) 5-year DFS (%) HL With IFRT 62 79 Without IFRT 37 68 p-value .07 .41 Aggressive NHL With IFRT 57 65 Without IFRT 37 49 p-value .02 .07 Indolent HNL With IFRT 50 67 Without IFRT 85 88 p-value .06 .30 On multivariate analysis, for ANHL, IFRT was protective (p = .002, Hazard Ratio = 0.39) and bulky disease was adverse (p = .04, HR = 2.04). For HL, an advantage of IFRT did not reach statistical significance (p = .63, HR = .8). For INHL, IFRT was associated with an inferior outcome (p = .23, HR = 4.9). Conclusion: Recognizing that bias exists in patient selection for IFRT post-ASCR (in both directions), a survival benefit appears to exist for patients with ANHL, and potentially for those with HL. The absence of a difference in DFS may relate to relapses in other sites or competing events with censored data. Longer follow-up or larger patient numbers are necessary to confirm a long- term improvement. INHL did not benefit from IFRT as might be expected since this group is more likely to have occult disseminated, chemotherapy insensitive disease. Determination of specific patterns of disease recurrence is in progress.

scholarly journals Successful Treatment in Children with Hodgkin Lymphoma in Greece; A 20-Year Experience in a Single Institution

Lymphoma ◽  
2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Apostolos Pourtsidis ◽  
Dimitrios Doganis ◽  
Margarita Baka ◽  
Despina Bouhoutsou ◽  
Maria Varvoutsi ◽  
...  
Keyword(s):  
Hodgkin Lymphoma ◽  
Low Dose ◽  
Disease Stage ◽  
Combined Modality Treatment ◽  
Single Institution ◽  
Number Of Patients ◽  
Long Time ◽  
Field Radiation ◽  
Advanced Disease Stage ◽  
Involved Field

During the last 30 years, combined chemotherapy regimens with radiotherapy or not significantly improved the prognosis for patients with Hodgkin lymphoma. We retrospectively studied 58 children (35 boys and 23 girls) with Hodgkin lymphoma who were treated at our institution during the period 1987–2006 and we correlated age, sex, stage, histology, and therapy with the outcome of patients. Of our patients, 9 children were 8 years old or younger. Nodular sclerosis was the predominant histology subtype (69%), whereas 26 patients (45%) had advanced disease (stage III or IV). Chemotherapy (CT) with various drug combinations, according to the period of treatment plus low-dose involved field radiation therapy (IFRT), was used in all patients. Five children experienced relapse and in 3 other patients second or third malignancies were documented. The overall survival was found to be 98%. No factors related to the outcome could be detected. The prognosis of children with Hodgkin lymphoma is excellent with CT combined with low dose IFRT but in long-time survivors late effects of the combined modality treatment are still issues of major concern. Longer followup of a greater number of patients is necessary to detect prognostic factors related to the outcome of children with Hodgkin lymphoma and to identify some patients who would be treated without radiation.

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