Strahlenbehandlung von follikulären Keimzentrumslymphomen

Abstract

On the basis of these results radiotherapy is a potentially curative therapeutic approach in stages I, II and limited III of follicle centre lymphoma. The optimal technique is total lymphoid irradiation with doses of 30 Gy in the adjuvant situation and 40 to 44 Gy in enlarged lymphomas. The number of local recurrences leads to the assumption, that the extension of radiotherapy to the total lymphoid system might reduce their frequency.

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

“…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.…”

“…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.…”

“…[14] found a clear dose-effect correlation for radiation doses ranging from 25-44 Gy in involved lymph node regions. The results from the German multicenter study [40,47] also point out a dose level for tumor control in the involved areas: The study had shown a probability of recurrence of 11% in 7 years after treatment with a dose of 36 Gy. Underdosage of more than 20% of the prescribed dose of 36 Gy, i.e.…”

“…The results of our retrospective investigation are best compared to the German multicenter study [40,47] in view of the histologic classification used (Kiel classification). Both studies observed a dose-effect relationship which is largely equivalent, while in our investigation it is based on a rather small patient population.…”

“…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].…”