A Systematic Overview of Radiation Therapy Effects in Non-Hodgkin's Lymphoma

Gustavsson, Anita; Osterman, Birgitta; Cavallin‐Ståhl, Eva

doi:10.1080/02841860310014435

Cited by 55 publications

(29 citation statements)

References 62 publications

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“…44 Reductions in radiotherapy field sizes and treatment doses for HL and NHL have been made to address the known increased risks for second cancers and cardiac complications caused by radiotherapy. [45][46][47] It is only very recently, however, that epidemiology studies have shown associations between mesothelioma and radiation treatment for NHL and testicular cancer. 7,19 Travis et al 7 used SEER data through 2001, enhanced by data from other population-based registries in Canada and Europe, to identify 40,576 survivors of testicular cancer who were followed for second cancers.…”

Section: Discussionmentioning

confidence: 99%

Therapeutic radiation for lymphoma

Teta

Lau

Sceurman

et al. 2007

Cancer

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BACKGROUNDIonizing radiation has been used since the 1950s to treat a variety of cancers. Cancer patients who are treated with radiotherapy have shown increased risks for a variety of second malignancies, including mesothelioma, in several recent reports. The only existing study of Hodgkin lymphoma (HL) and subsequent mesothelioma had a short observation period.METHODSThe authors used Surveillance, Epidemiology, and End Results data over a 30‐year period to identify patients with HL and non‐Hodgkin lymphoma (NHL) who also were diagnosed with mesothelioma. Standardized incidence ratios (SIR) and absolute excess risks were calculated by sex and treatment modality for both types of lymphoma.RESULTSTwenty‐six patients were identified who had mesothelioma as second primaries based on 21,881 diagnoses of HL and 101,001 diagnoses of NHL. There was a statistically significant increase in mesothelioma (4 diagnoses; SIR, 6.59; 95% confidence interval [95% CI], 1.79–16.87) among men with HL who received radiation, but no women survivors were identified who had a diagnosis of mesothelioma. For NHL survivors, there was a nonsignificant excess of mesothelioma among men (SIR, 1.91; 95% CI, 0.77–3.93) and women (SIR, 3.75; 95% CI, 0.77–10.95) who had received radiation treatment. There were no increases among patients who were unirradiated.CONCLUSIONSMesothelioma rates for patients who had received radiotherapy were increased for survivors of HL and NHL. No increases were observed among the unirradiated. These findings and the existing body of supporting studies confirmed that radiotherapy is a cause of mesothelioma. Cancer 2007. © 2007 American Cancer Society.

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Section: Discussionmentioning

confidence: 99%

Therapeutic radiation for lymphoma

Teta

Lau

Sceurman

et al. 2007

Cancer

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“…Similarly, previous studies of nodal cases found that the clinical staging of follicular lymphoma patients needed to be modified in 18% to 31% of cases based on 18F-FDG-PET results [17,19,22] . This aspect is particularly vital for stage Ⅰ or stage Ⅱ patients under consideration for radiotherapy as a curative treatment, since most treatment failures occur outside the involved field of radiotherapy [56] . Thirdly, 18F-FDG-PET can be used to evaluate treatment response if a patient has 18F-FDG-avid gastrointestinal lesions.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic role of 18F-fluorodeoxyglucose positron emission tomography for follicular lymphoma with gastrointestinal involvement

Iwamuro

Okada²,

Takata³

et al. 2012

WJG

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AIM:To investigate the capacity for 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET) to evaluate patients with gastrointestinal lesions of follicular lymphoma. METHODS:This retrospective case series consisted of 41 patients with follicular lymphoma and gastrointestinal involvement who underwent 18F-FDG-PET and endoscopic evaluations at ten different institutions between November 1996 and October 2011. Data for endoscopic, radiological, and biological examinations performed were retrospectively reviewed from clinical records. A semi-quantitative analysis of 18F-FDG uptake was performed for each involved area by calculating the maximum standardized uptake value (SUVmax). Based on the positivity of 18F-FDG uptake in the gastrointestinal lesions analyzed, patients were subdivided into two groups. To identify potential predictive factors for 18F-FDG positivity, these two groups were compared with respect to gender, age at diagnosis of lymphoma, histopathological grade, pattern of follicular dendritic cells, mitotic rate, clinical stage, soluble interleukin-2 receptor levels detected by 18F-FDG-PET, lactate dehydrogenase (LDH) levels, hemoglobin levels, bone marrow involvement, detectability of gastrointestinal lesions by computed tomography (CT) scanning, and follicular lymphoma international prognostic index (FLIPI) risk. ORIGINAL ARTICLE RESULTS:Involvement of follicular lymphoma in the stomach, duodenum, jejunum, ileum, cecum, colon, and rectum was identified in 1, 34, 6, 3, 2, 3, and 6 patients, respectively. No patient had esophageal involvement. In total, 19/41 (46.3%) patients exhibited true-positive 18F-FDG uptake in the lesions present in their gastrointestinal tract. In contrast, false-negative 18F-FDG uptake was detected in 24 patients (58.5%), while false-positive 18F-FDG uptake was detected in 5 patients (12.2%). In the former case, 2/19 patients had both 18F-FDG-positive lesions and 18F-FDGnegative lesions in the gastrointestinal tract. In patients with 18F-FDG avidity, the SUVmax value of the involved gastrointestinal tract ranged from 2.6 to 17.4 (median: 4.7). For the 18F-FDG-negative (n = 22) and -positive (n = 19) groups, there were no differences in the male to female ratios (10/12 vs 4/15, P = 0.186), patient age (63.6 ± 2.4 years vs 60.1 ± 2.6 years, P = 0.323), presence of histopathological grade 1 vs 2 (20/2 and 17/2, P = 1.000), follicular dendritic cell pattern (duodenal/nodal: 13/5 vs 10/3, P = 1.000), mitotic rate (low/ partly high, 14/1 vs 10/3, P = 0.311), clinical stage according to the Ann Arbor system (stages ⅠE and ⅡE/ other, 15/7 vs 15/4, P = 0.499), clinical stage according to the Lugano system (stages Ⅰ and Ⅱ-1/other, 14/8 vs 14/5, P = 0.489), soluble interleukin-2 receptor levels (495 ± 78 vs 402 ± 83, P = 0.884), LDH levels (188 ± 7 vs 183 ± 8, P = 0.749), hemoglobin levels (13.5 ± 0.3 vs 12.8 ± 0.4, P = 0.197), bone marrow involvement (positive/negative, 1/8 vs 1/10, P = 1.000), detectability by CT scanning (positive/negative, 1/16 vs 4/13, P = 0.335...

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“…Many of these patients are managed with localized radiotherapy but only 30-50 % experience durable remissions following staging with conventional imaging [93]. Management strategy may be redirected to observation or systemic therapy if upstaged to stage III or IV.…”

Section: Staging Of Indolent Lymphomamentioning

confidence: 98%

Current status of FDG-PET/CT in staging of adult lymphoma

Biggi

Guerra

Hofman

2015

Clin Transl Imaging

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Staging defines disease location and extent, suggests prognostic information and provides a baseline against which response or disease progression can be compared. Studies in Hodgkin (HL) and non-Hodgkin lymphoma (NHL) generally conclude that PET/CT is more accurate for diagnosing both nodal and extranodal disease than computed tomography (CT), thus having a strong potential impact on the staging of these lymphomas. Due to the high sensitivity and specificity of PET/CT in detecting bone marrow disease in newly diagnosed HL, bone marrow biopsy (BMB) is no longer indicated in HL; in aggressive NHL the detection of bone marrow involvement is still a topic of debate. In patients with a negative PET/CT, BMB is currently suggested to identify discordant histology, but its clinical role need to be further investigated. In indolent lymphoma FDG-PET enables staging the disease and characterization of intensity of glycolytic metabolism and this information provides additional prognostic information. In indolent lymphoma the pattern of marrow involvement is diffuse and PET/CT can be false negative in many cases. The main criteria to interpret staging PET/CT were reviewed. In 2014 were published the updated guidance on the evaluation, staging and response assessment of patients affected by HL and NHL and on the use of PET/ CT for staging and response assessment. The guidelines suggest that a reasonable approach would be omit the standard full dose contrast-enhanced CT (ceCT) if not already performed, and perform a low-dose non-enhanced PET/CT as a single imaging modality, with ceCT performed selectively determined by PET/CT findings.

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A Systematic Overview of Radiation Therapy Effects in Non-Hodgkin's Lymphoma

Cited by 55 publications

References 62 publications

Therapeutic radiation for lymphoma

Therapeutic radiation for lymphoma

Diagnostic role of 18F-fluorodeoxyglucose positron emission tomography for follicular lymphoma with gastrointestinal involvement

Current status of FDG-PET/CT in staging of adult lymphoma

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