Post-excision RT shows significant reduction in keloid recurrence compared to excision alone. While the recurrence control rates are not statistically different between EBRT and brachytherapy, keloids treated with EBRT recurred significantly later than those treated by HDR brachytherapy by a mean of 2.5 years. Further workup with a randomized control study will help to refine optimal adjuvant RT treatment. LEVEL OF EVIDENCE 3.
Ann Oncol 2008) reviewed the patient treated from 1980 to 2003. The purpose of this study is to evaluate the treatment results and toxicity of patients with breast lymphomas treated in modern era. Materials/Methods: We reviewed consecutive 23 patients with early stage breast lymphoma treated by radiation therapy with/without pharmaceutical therapy between 1997 and 2013 at single institution. All patients were histologically proven with malignant lymphoma. Information of patient characteristics, detailed radiation treatment, toxicities, relapses and salvages treatment, and outcomes were collected with chart review. Results: The characteristics of patients were following; median age 56 years (range, 17-80 years old), female:23, clinical stage I:14 II:8, pathology DLBCL:20 MZBCL:2 ALCL:1. As an initial treatment, RCHOP was prescribed for 13 DLBCL patients, CHOP4/6 was for 4, and EPOCH was for 2. Of them, 3 patients received intra-thecal MTX. Two patients with MZBCL were treated with radiation therapy alone without any chemotherapy. The median radiation dose was 40 Gy (range, 30-54). The IFRT was delivered to the whole breast for stage I patients and EFRT was delivered to the whole breast and regional lymph nodes for stage II patients. The median follow up time was 66 months (range 3-180). Three patients died with lymphoma, 1 died of other disorder, and 19 patients are alive without any evidence of relapse. The local control was achieved in all 23 patients. One patient developed marginal relapse close to the IFRT field. There were 4 relapses documented outside the irradiated fields; 2 distant lymph nodes, 1 bone and 1 bone marrow respectively. Two systemic DLBCL relapse of 4 were developed 15 years after initial treatment. There was no CNS relapse in this series. No toxicities greater than grade 2 were observed during treatment and over follow up time. Conclusion: The radiation therapy for breast lymphomas provides excellent local control with low toxicities. The CNS prophylaxis might be safely omitted for low IPI patients with breast lymphomas. We have to pay attention to the delayed relapsed 10 years or later.
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