FoRT: A Phase 3 Multi-Center Prospective Randomized Trial of Low Dose Radiation Therapy for Follicular and Marginal Zone Lymphoma

Hoskin, P.; Kirkwood, Amy A.; Popova, B.; Brammer, Caroline; Díez, Patricia; Robinson, Martin; Syndikus, Isabel; Jack, Andrew; Smith, Paul D.

doi:10.1016/j.ijrobp.2012.11.016

Cited by 6 publications

(4 citation statements)

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“…A U.K. RCT has shown that 4 Gy in two fractions can be effective in the palliative setting, with an ORR of 74·1% (complete response rate 44·3%). However, this was significantly inferior to 24 Gy in 12 fractions, with an ORR of 81% and complete response rate of 60·3% . The OS rate was the same with both fractionations but there were fewer patients with PCMZL or PCFCL in this study.…”

Section: Treatment Of Primary Cutaneous B‐cell Lymphomasmentioning

confidence: 57%

British Association of Dermatologists and U.K. Cutaneous Lymphoma Group guidelines for the management of primary cutaneous lymphomas 2018

et al. 2018

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Section: Treatment Of Primary Cutaneous B‐cell Lymphomasmentioning

confidence: 57%

British Association of Dermatologists and U.K. Cutaneous Lymphoma Group guidelines for the management of primary cutaneous lymphomas 2018

et al. 2018

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“…A number of retrospective cohort studies have demonstrated that patients with advanced or recurrent indolent lymphoma treated with very low doses of only 4 Gy in 2 fractions achieve high response rates, and the treatment provides effective palliation for localized symptomatic disease (36)(37)(38)(39)(40)(41). Initial results from a prospective, randomized trial in the United Kingdom comparing 4 Gy with 24 Gy for follicular lymphoma (41) suggest that there is only a modest decrease in local control with the lower dose. In some cases patients may benefit from RT to sites of bulky disease, such as within the retroperitoneum where monitoring clinical progression is challenging and progressive disease may lead to organ failure.…”

Section: Advanced-stage Indolent Lymphomamentioning

confidence: 99%

Modern Radiation Therapy for Nodal Non-Hodgkin Lymphoma—Target Definition and Dose Guidelines From the International Lymphoma Radiation Oncology Group

Illidge

Specht

Yahalom

et al. 2014

International Journal of Radiation Oncology*Biology*Physics

271

160

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“…Patients with a poor performance status or who are traveling from long distances can easily undergo this form of treatment. However, while 4 Gy can be effective in the palliative setting, local control is significantly inferior to 24 Gy (5-year local progression-free rate is 89.9% after 24 Gy and 70.4% after 4 Gy), which remains the treatment schedule of choice for curative radiation therapy in MZL [ 34 , 74 , 111 ].…”

Section: Future Directions: Standard Intermediate or Ultra Low-dose R...mentioning

confidence: 99%

Development of Organ-Preserving Radiation Therapy in Gastric Marginal Zone Lymphoma

Rolf

Reinartz

Rehn

et al. 2022

Cancers

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Gastric marginal zone lymphoma (gMZL) of mucosa-associated lymphoid tissue (MALT) may persist even after H. pylori eradication, or it can be primarily Helicobacter pylori (H. pylori) independent. For patients without the successful eradication of lymphoma, or with progressive disease, treatment options have historically included partial or total gastrectomy. Presently, in these instances, curative radiation therapy (RT) is the current standard of care. This review emphasizes the historically changing role of radiation therapy in gMZL, progressing from large-volume RT without surgery, to localized RT, on its own, as a curative organ-preserving treatment. This overview shows the substantial progress in radiation therapy during the recent two to three decades, from high-dose, large-field techniques to low-dose, localized target volumes based on advanced imaging, three-dimensional treatment planning, and advanced treatment delivery techniques. RT has evolved from very large extended field techniques (EF) with prophylactic treatment of the whole abdomen and the supradiaphragmatic lymph nodes, applying doses between 30 and 50 Gy, to involved-field RT (IF), to the current internationally recommended involved site radiation therapy (ISRT) with a radiation dose of 24–30 Gy in gMZL. Stage-adapted RT is a highly effective and safe treatment with excellent overall survival rates and very rare acute or late treatment-related toxicities, as shown not only in retrospective studies, but also in large prospective multicenter studies, such as those conducted by the German Study Group on Gastrointestinal Lymphoma (DSGL). Further de-escalation of the radiation treatments with low-dose 20 Gy, as well as ultra-low-dose 4 Gy radiation therapy, is under investigation within ongoing prospective clinical trials of the International Lymphoma Radiation Oncology Group (ILROG) and of the German Lymphoma Alliance (GLA).

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FoRT: A Phase 3 Multi-Center Prospective Randomized Trial of Low Dose Radiation Therapy for Follicular and Marginal Zone Lymphoma

Cited by 6 publications

References 0 publications

British Association of Dermatologists and U.K. Cutaneous Lymphoma Group guidelines for the management of primary cutaneous lymphomas 2018

British Association of Dermatologists and U.K. Cutaneous Lymphoma Group guidelines for the management of primary cutaneous lymphomas 2018

Modern Radiation Therapy for Nodal Non-Hodgkin Lymphoma—Target Definition and Dose Guidelines From the International Lymphoma Radiation Oncology Group

Development of Organ-Preserving Radiation Therapy in Gastric Marginal Zone Lymphoma

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