Evaluating the effectiveness and safety of radiotherapy for the treatment of patients with painless non-Hodgkin lymphoma.

This study evaluated the effectiveness and safety of radiotherapy (RT) for the treatment of patients with indolent (painless) non-Hodgkin lymphoma (iNHL). The data showed that RT was highly effective with manageable side effects in these patients.

Non-Hodgkin lymphoma (NHL) is a cancer that starts in white blood cells called lymphocytes, which are part of the body’s immune system. Indolent non-Hodgkin lymphoma (iNHL) is a type of NHL that grows and spreads slowly and usually has very few symptoms. Common iNHLs include follicular lymphomas (FL), marginal-zone lymphoma (MZL), lymphoplasmacytic lymphoma (LPL)/Waldenström macroglobulinemia (WM), and small lymphocytic lymphoma (SLL).

RT is usually recommended as the first choice of treatment for patients with iNHL. However, in the last two decades, there has been a decline in the use of RT especially in patients with FL. It is important to reestablish the effectiveness and safety of RT for the treatment of patients with iNHL.

This study involved 75 patients with iNHL. All patients were treated with RT between 1999 and 2016. The average follow-up time was 87 months. The average single dose of RT per fraction was 2.0 Gy and the average total dose was 30.6 Gy.

The average survival without cancer worsening was 14 years. 73% of the patients were alive without cancer worsening after 5 years and 65.5% after 10 years. Overall, 88.6% of the patients were alive after 5 years and 73.9% were alive after 10 years.

The local control rate (the tumor does not grow or spread) was 94.9% after 5 years and 92.3% after 10 years.

Patients less than 60 years old had a significantly longer survival rate without cancer worsening (81.9%) compared to patients aged more than 60 years old (65.1%).

The most common side effects were skin inflammation (8%), dry mouth (8%), cataracts (12%), and dry eyes (14.6%). Patients recovered from skin inflammation and dry eyes within 3 to 6 months after RT.

This study concluded that RT was highly effective with manageable side effects in patients with iNHL.

This study looked back in time at medical records. The sample size was small and only included patients from a single institution in Germany. It also did not include a comparison group.