Extended field and total central lymphatic radiotherapy in the treatment of early stage lymph node centroblastic-centrocytic lymphomas

Stuschke, Martin; Hoederath, A.; Sack, H.; Pötter, Richard; Müller, R. P.; Schulz, Ulrich; Karstens, Johann H.; Makoski, H. B.

doi:10.1002/(sici)1097-0142(19971215)80:12<2273::aid-cncr9>3.0.co;2-v

Cited by 67 publications

(48 citation statements)

References 58 publications

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“…Our 5-year overall survival rate and relapse free survival rate for Stages I and II compare favorably with data of other studies [1,5,8,10,15,19,25,27,28,31,33,36,40,47,49,52]. For Stage III NHL overall survival is also comparable to data published in the literature [7,18,29,34], however, recurrences occurred more frequently in our analysis.…”

Section: Survival Datasupporting

confidence: 90%

“…For this analysis Stage I/II patients were divided into two groups depending on the extent of radiotherapy: the first group contains patients treated with IF-RT (which was widely used before the starting of the German NHL study [38,40,47], the second group consists of patients treated with EF-RT or TLI. The latter treatment strategy corresponds to the treatment recommendations of the study protocol just mentioned: for supradiaphragmatic peripheral involvement (Stages I/II) treatment portals consisted of a mantle field (with or without Waldeyer's fields) and a periaortic field.…”

Section: Radiation Therapymentioning

confidence: 99%

“…From what we know by now, EF-RT or total lymphatic irradiation (TLI) does not yield prolonged overall survival compared to local IF-RT [27,33,36]. Published data mostly report doses of at least [30][31][32][33][34][35] Gy for the treatment of involved regions in localized, follicular low-grade NHL [5,8,13,19,25,26,33,35,40,47].…”

Section: Introductionmentioning

confidence: 99%

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Centroblastic-Centrocytic Non-Hodgkin's Lymphoma Stage I–III: Patterns of Failure Following Radiotherapy

Frank¹,

Zierhut²,

Schulz-Ertner³

et al. 2001

Strahlenther Onkol

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In involved lymph node regions a relatively small number of relapses was observed after application of a minimal dose of 36 Gy. In Stages I/II most relapses were located outside the radiation portals, yet EF-RT was not superior to IF-RT in terms of overall survival and relapse free survival. Prospective randomized trials are necessary to prove a potentially favorable effect of more extended radiotherapy portals (TLI or TNI [total nodal irradiation]) and to evaluate the optimal radiotherapy dose.

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Section: Survival Datasupporting

confidence: 90%

Section: Radiation Therapymentioning

confidence: 99%

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Centroblastic-Centrocytic Non-Hodgkin's Lymphoma Stage I–III: Patterns of Failure Following Radiotherapy

Frank¹,

Zierhut²,

Schulz-Ertner³

et al. 2001

Strahlenther Onkol

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“…A German prospective multicentre study recommends 36 Á/44 Gy for involved lymph nodes (13). In a retrospective analysis from Florida no local recurrences occurred after 30 Gy, suggesting that most indolent lymphomas are adequately treated with 30 Gy (11).…”

Section: Indolent Non-hodgkin's Lymphomasmentioning

confidence: 99%

“…The median follow-up was 68 months and the relapse rate at 7 years was 26% in stage I and 44% in stage II (13). Results of TCL irradiation of about 100 patients in limited stage III are published and one of these reports suggests a possible increase of second malignancies (14).…”

Section: Indolent Non-hodgkin's Lymphomasmentioning

confidence: 99%

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

2003

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Hematologic recovery after central lymphatic irradiation for patients with stage I-III follicular lymphoma

Tucker

Blanco

et al. 2001

Cancer

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BACKGROUND The authors previously reported that central lymphatic irradiation (CLI) can induce molecular remission in patients with Stage I–III follicular lymphoma, as measured by polymerase chain reaction analysis for t(14;18) (q32;q21). Hematologic toxicity has been considered a major consequence of CLI. This study was undertaken to analyze the patterns of hematologic recovery after CLI. METHODS Thirty‐three patients with Stage I–III follicular lymphoma were treated with CLI between January 1993 and February 1998. CLI consisted of irradiation to mantle, upper two‐thirds of abdomen, and pelvic fields. Each field was treated to 30.0–30.6 grays (Gy) at 1.5–1.8 Gy per fraction, with a boost to 36.0–39.6 Gy at the same rate to the sites of macroscopic disease. A break of approximately 4 weeks was given after treatment of each field. Twenty‐four patients who were followed for a minimum of 1 year from the end of CLI form the basis of this analysis. Fourteen patients were male. Three patients had Stage I disease, 6 patients had Stage II disease, and 15 patients had Stage III disease. The International Prognostic Index (IPI) for malignant lymphoma was 0 for 5 patients, 1 for 13 patients, and 2 for 6 patients. The Eastern Cooperative Oncology Group performance status was 0 for 21 patients and 1 for 3 patients. The median values for their pretreatment characteristics were as follows: age, 60 years (range, 34–73 years); height, 173 cm (range, 155–193 cm); weight, 79 kg (range, 57–107 kg); body surface area (BSA), 1.95 m2 (range, 1.61–2.31 m2); bone marrow cellularity, 27%(range, 2–75%), platelet count, 233,000/mm3 (range, 139,000–339,000/mm3), white blood cell (WBC) counts, 6400/mm3 (range, 4200–10,900/mm3); and hemoglobin, 14.5 mg/dL (range, 11.8 –16.6 mg/dL). The median duration of CLI was 159 days (range, 137–345 days). Ten patients had cardiovascular disease. The number of sites receiving a boost dose of ≥ 36.0 Gy was 0 sites in 1 patient, 1 site in 6 patients, 2 sites in 11 patients, 3 sites in 5 patients, and 4 sites in 1 patient. The platelet, hemoglobin, and WBC counts were followed every 3 months after completion of CLI. These counts were normalized to the pretreatment counts for statistical analyses. Univariate and multivariate analyses were performed to investigate the correlations between patient factors and hematologic status at 1 year posttreatment. Pearson correlation analysis was used for the continuous factors (patient age, height, weight, BSA, bone marrow cellularity, and duration of CLI), and the Mann–Whitney test was used for categoric factors (IPI, gender, performance status, stage, number of sites receiving ≥ 36.0 Gy, and presence or absence of cardiovascular disease). RESULTS There was continued recovery, essentially approaching the pretreatment levels, over 3 years for platelet, WBC, and hemoglobin counts. Factors that were associated significantly with normalized platelet counts at 1 year by univariate analyses were age (P = 0.015) and cardiovascular disease (P = 0.041). Age was the only s...

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Extended field and total central lymphatic radiotherapy in the treatment of early stage lymph node centroblastic-centrocytic lymphomas

Cited by 67 publications

References 58 publications

Centroblastic-Centrocytic Non-Hodgkin's Lymphoma Stage I–III: Patterns of Failure Following Radiotherapy

Centroblastic-Centrocytic Non-Hodgkin's Lymphoma Stage I–III: Patterns of Failure Following Radiotherapy

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

Hematologic recovery after central lymphatic irradiation for patients with stage I-III follicular lymphoma

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