Long-term outcome and mortality trends in early-stage, Grade 1–2 follicular lymphoma treated with radiation therapy

Guadagnolo, B. Ashleigh; Li, Sigui; Neuberg, Donna; Ng, Andrea K.; Hua, Lei; Silver, Barbara; Stevenson, Mary Ann; Mauch, Peter

doi:10.1016/j.ijrobp.2005.08.010

Cited by 140 publications

(106 citation statements)

References 26 publications

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“…patients with a localized relapse had a favourable outcome. This is in accordance with large series of early stage follicular lymphoma (Fung et al 2003;Guadagnolo et al 2006;Pugh et al 2010). It is noteworthy that only three of the 17 patients with limited-stage disease died of lymphoma.…”

Section: Discussionsupporting

confidence: 91%

Follicular lymphoma of the ocular adnexal region: A nation‐based study

Rasmussen

Ralfkiær

Prause

et al. 2014

Acta Ophthalmologica

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ABSTRACT.Purpose: To characterize the clinicopathological features of follicular lymphoma of the ocular adnexal region. Methods: Retrospective nation-based study of Danish patients with ocular adnexal follicular lymphoma from January 1st 1980 through December 31st 2009. Results: Twenty-four patients with ocular adnexal follicular lymphoma were identified. Fourteen (58%) of the patients were females. The median age was 63 years (range: 42-96 years). Eleven (46%) of the patients had primary ocular adnexal lymphoma, seven (29%) had an ocular adnexal lesion in conjunction with a concurrent systemic lymphoma and six patients (25%) presented with an ocular adnexal relapse. The most frequently affected sites were the lacrimal gland (38%) and the orbit (33%). Thirteen patients (54%) presented with Ann Arbor stage IE lymphoma, four (17%) had stage IIE, two patients (8%) stage IIIE, and five patients (21%) had stage IV lymphoma. Radiotherapy was primarily used in patients with primary lymphoma and those with a stage IE/IIE relapse (82%), while stage IIIE/IV lymphomas most frequently received alkylating chemotherapy (67%). Complete remission was observed in 19 of the patients (79%), but of these 11(58%) had a relapse. The 10-year overall survival for the entire cohort was 59%. The translocation t(14;18) was detected in 16 patients (16/24, 76%). Recurrence was only observed in patients with the t(14;18) (p = 0.05, log-rank). Conclusions: Ocular adnexal follicular lymphoma is more commonly found in elderly female patients. The lacrimal gland is relatively frequently involved. Radiotherapy is the treatment of choice for localized ocular adnexal follicular lymphoma providing a favourable prognosis for majority of patients.

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Section: Discussionsupporting

confidence: 91%

Follicular lymphoma of the ocular adnexal region: A nation‐based study

Rasmussen

Ralfkiær

Prause

et al. 2014

Acta Ophthalmologica

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“…With the exception of a minority of patients who present with localized disease in which radiation therapy alone may have a curative role [2][3][4][5], it is considered a largely incurable disease. Disease progression is characterized by multiple relapses with spontaneous remission and transformation to more aggressive lymphomas in some cases.…”

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confidence: 99%

Response to low-dose involved-field radiotherapy in patients with non-Hodgkin's lymphoma

Luthy

Silver

et al. 2008

Annals of Oncology

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Background: The purpose of this study was to analyze response to palliative low-dose involved-field radiotherapy (LD-IF-RT) (two 2-Gy fractions), explore factors predicting for response, and determine the time course to subsequent treatment.Patients and methods: Thirty-three patients with advanced or recurrent indolent non-Hodgkin's lymphoma (NHL) received LD-IF-RT to 43 sites. Response was assessed by physical examination and radiographic studies. Median follow-up for individual sites was 14 months. Fisher's exact test was used to evaluate prognostic factors for response and in-field progression.Results: Overall response was 95%. Thirty-six sites (84%) had a complete response (CR), five sites (12%) had a partial response, and two sites (5%) had progressive disease. The CR rate of head and neck sites was significantly higher than that of pelvic and/or inguinofemoral sites (95% versus 64%, P = 0.04). The CR rate was significantly higher for sites £40 mm than for sites >40 mm (90% versus 56%, P = 0.04). Ten sites (23%) had in-field progression diagnosed at a median of 9 months. Sixteen patients (48%) received systemic treatment at a median of 8 months. Fourteen patients (42%) did not require additional treatment.Conclusions: LD-IF-RT for selected NHL subtypes has excellent local CR and in-field control rates and may postpone the need for systemic therapy.

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“…Six developed local relapse after a median follow-up of 4.2 years, whereas no local relapse was observed in the irradiated group. In general, the local relapse rate after irradiation for early-stage FL is less than 10%, [22][23][24] demonstrating the effectiveness of irradiation for local control. Furthermore, considering irradiation as the only strategy with benefits in terms of overall survival for early-stage FL, 7,19,20 irradiation is one of the most important treatment strategies, as reflected in several guidelines and review articles for early-stage FL.…”

Section: Discussionmentioning

confidence: 94%

Clinical management and outcomes of completely resected stage I follicular lymphoma

Yokohama

Hashimoto

Takizawa

et al. 2018

J Clin Exp Hematopathol

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JC EH lin xp ematopathol Original Article INTRODUCTIONFollicular lymphoma (FL) is the second-most common type of non-Hodgkin lymphoma in the United States and Europe, 1,2 and is increasing in frequency even in Japan. 3 FL is characterized by indolent clinical behavior and subsequent histological transformation linked with an aggressive clinical course and poor outcomes. A substantial number of patients exhibit no clinical symptoms and do not need immediate treatment irrespective of clinical stage, although FL is recognized as an incurable malignant disease.The treatment modality for patients with malignant lymphoma is generally selected based on clinical stage being early or advanced. 4 For early-stage FL, involved-field irradiation therapy is recommended by published guidelines. 5,6 Moreover, irradiation is the only treatment strategy to demonstrate any advantage in terms of overall survival, although the evidence for this was obtained from retrospective studies. 7,8 However, the reality is that several treatment strategies have been applied for patients with early-stage FL, including combined-modality therapy (CMT), irradiation alone, watch-and-wait (WW), and more recently, rituximab (R)-containing chemotherapy or R monotherapy, 9-11 probably because recommendations have been based on relatively small, retrospective studies from a single center. Of these, 18 patients underwent total resection after diagnostic tissue biopsy. We used 18 F-fluorodeoxyglucose positron emission CT for staging assessment in 13 of 18 patients (72.2%). The median age was 56.5 years. Six patients (33.3%) were male. The soluble interleukin-2 receptor alpha concentration was significantly lower than in patients with residual disease. Among these 18 patients, 7 patients (38.9%) were treated with a "watch-and-wait" (WW) policy, 7 (38.9%) were treated with involved-field irradiation, and 4 (22.2%) received systemic chemotherapy. Patients with resected disease were treated with significantly different strategies from those with residual disease (p = 0.0026). Five patients experienced relapse during follow-up (median follow-up: 48.2 months). All relapses were distant from the primary site, irrespective of treatment strategy. Among all stage I patients, disease resection was not a significant factor for survival (p = 0.9294). Collectively, the choice of treatment strategy was significantly influenced by patient status. Resection status was not significantly associated with survival after several treatment strategies.

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Long-term outcome and mortality trends in early-stage, Grade 1–2 follicular lymphoma treated with radiation therapy

Cited by 140 publications

References 26 publications

Follicular lymphoma of the ocular adnexal region: A nation‐based study

Follicular lymphoma of the ocular adnexal region: A nation‐based study

Response to low-dose involved-field radiotherapy in patients with non-Hodgkin's lymphoma

Clinical management and outcomes of completely resected stage I follicular lymphoma

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