Low-Dose Involved-Field Radiation in the Treatment of Non-Hodgkin Lymphoma: Predictors of Response and Treatment Failure

Russo, Andrea; Chen, Yu Hui; Martin, Neil E.; Vinjamoori, Anant; Luthy, Sarah K.; Freedman, Arnold S.; Michaelson, Evan M.; Silver, Barbara; Mauch, Peter; Ng, Andrea K.

doi:10.1016/j.ijrobp.2012.12.024

Cited by 50 publications

(37 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…One of the 3 patients who did not have a CR after 4 Gy to the orbit had an unclassifiable low-grade B-cell lymphoma with 3 monoclonal B-cell populations detected in the biopsy specimen, including cells suggestive of small lymphocytic lymphoma/chronic lymphocytic leukemia, a disease that has been shown not to respond well to palliative doses of 4 Gy. 18 Ultimately, this patient had complete regression of his orbital lymphoma after an additional 20 Gy was administered. This staged approach to therapy, in which patients with suboptimal responses to 4 Gy go on to receive an additional 20 Gy, is currently the focus of an ongoing prospective trial at our institution (NCT02494700).…”

Section: Discussionmentioning

confidence: 88%

See 1 more Smart Citation

Ultra–low‐dose radiotherapy for definitive management of ocular adnexal B‐cell lymphoma

et al. 2017

View full text Add to dashboard Cite

Background. The purpose of this study was to report the response to and toxicity of ultra–low-dose radiotherapy (RT) for B-cell ocular adnexal lymphoma (OAL). Methods. We conducted a retrospective review of patients with indolent B-cell and mantle cell OAL treated with 4 Gy to the orbit(s) in two 2-Gy fractions. Disease response was assessed clinically and/or radiographically at 2 to 4-month intervals after RT. Data collected included rates of overall response, complete response (CR), partial response (PR), and treatment-related toxic effects. Results. Twenty-two patients (median age, 65 years) had the following histologic subtypes: mucosa-associated lymphoid tissue (MALT; 14 patients; 64%); follicular lymphoma (5 patients; 23%); mantle cell lymphoma (MCL; 2 patients; 9%); and unclassifiable (1 patient, 4%). The overall response rate was 100%; 19 patients (86%) had a CR and 3 patients (14%) had a PR. The only acute toxic effect was grade 1 dry eye syndrome in 1 patient. Conclusion. Ultra–low-dose RT in patients with OAL is associated with high response rates and minimal toxic effects, and is much shorter in duration and cost.

show abstract

Section: Discussionmentioning

confidence: 88%

“…Full workup consisted of a comprehensive ocular examination by a licensed ophthalmologist (B.E. ), basic laboratory studies, baseline volumetric imaging (fluorodeoxyglucose 18 F [FDG] positron emission tomography-CT or CT imaging of the neck, chest, abdomen, and pelvis), and bone marrow biopsy. The orbits were imaged with either CT or MRI.…”

Section: Methodsmentioning

confidence: 99%

Ultra–low‐dose radiotherapy for definitive management of ocular adnexal B‐cell lymphoma

et al. 2017

View full text Add to dashboard Cite

show abstract

“…TBI may be especially effective in highly radio-sensitive cancers such as CLL [15–17]. Consequently, we hypothesized that TBI-containing conditioning regimens may have better outcomes than CT conditioning regimens.…”

Section: Introductionmentioning

confidence: 99%

Does Total Body Irradiation Conditioning Improve Outcomes of Myeloablative Human Leukocyte Antigen–Identical Sibling Transplantations for Chronic Lymphocytic Leukemia?

Sabloff

Sobecks

Ahn

et al. 2014

Biology of Blood and Marrow Transplantation

View full text Add to dashboard Cite

An allogeneic hematopoietic cell transplant (HCT) from an HLA-identical donor after high-dose (myeloablative) pre-transplant conditioning, is an effective therapy for some people with chronic lymphocytic leukemia (CLL). Because CLL is a highly radiosensitive cancer, we hypothesized total body irradiation (TBI) conditioning regimens may be associated with better outcomes than those without TBI. To answer this we analyzed data from 180 subjects with CLL receiving myeloablative doses of TBI (N=126) or not (N=54), transplanted from an HLA-identical sibling donor, between 1995 and 2007 and reported to the Center for International Blood & Marrow Transplant Research (CIBMTR). At 5 years, treatment-related mortality was 48% (95% CI, 39–57%) vs. 50% (95% CI, 36–64%); p=NS. Relapse rates were 17% (95% CI, 11–25%) vs. 22% (95% CI, 11–35%); p=NS. Five-year progression-free survival and overall survival was 34% (95% CI, 26–43%) vs. 28% (95% CI, 15–42%); p=NS and 42% (95% CI, 33–51%) vs. 33% (95% CI, 19–48%); p=NS, respectively. The single most common cause of death in both cohorts was recurrent/progressive CLL. No variable tested in the multivariate analysis was found to significantly affect these outcomes including having failed fludarabine. Within the limitations of this study we found no difference in HLA-identical sibling transplant outcomes between myeloablative TBI and chemotherapy pre-transplant conditioning in persons with CLL.

show abstract

“…Regarding predictive/prognostic factors, Girinsky et al reported lower PFS rates for patients previously treated with more than two chemotherapy lines, and lower response rates for masses larger than 5 cm and patients treated at age > 65 years 38. Haas et al40 found no correlation between age, sex, follicular lymphoma grade, RT regimen, number of previous regimens and previous history, number of positive sites or largest lymphoma diameter and response rate; conversely, Russo et al42 showed that patients aged <50 years had lower PFS rates (and also those with CLL histology in comparison with other indolent NHL subtypes).…”

Section: Rt Dosementioning

confidence: 99%

Limited Stage Follicular Lymphoma: The Role of Radiation Therapy.

Filippi

Ciammella²,

Ricardi

2016

Mediterr J Hematol Infect Dis

View full text Add to dashboard Cite

Radiation therapy (RT) alone has been considered for a long time as the standard therapeutic option for limited stage FL, due to its high efficacy in terms of local disease control with a quite significant proportion of “cured” patients (without further relapses at 10–15 years). Multiple therapeutic choices are currently accepted for the management of early stage FL at diagnosis, and better staging procedures as well as better systemic therapy partially modified the role of RT in this setting. RT has also changed in terms of prescribed dose as well as treatment volumes. In this review, we present and discuss the current role of RT for limited stage FL in light of the historical data and the modern RT concepts along with the possible combination with systemic therapy.

show abstract

Low-Dose Involved-Field Radiation in the Treatment of Non-Hodgkin Lymphoma: Predictors of Response and Treatment Failure

Cited by 50 publications

References 15 publications

Ultra–low‐dose radiotherapy for definitive management of ocular adnexal B‐cell lymphoma

Ultra–low‐dose radiotherapy for definitive management of ocular adnexal B‐cell lymphoma

Does Total Body Irradiation Conditioning Improve Outcomes of Myeloablative Human Leukocyte Antigen–Identical Sibling Transplantations for Chronic Lymphocytic Leukemia?

Limited Stage Follicular Lymphoma: The Role of Radiation Therapy.

Contact Info

Product

Resources

About