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Posted by on Mar 17, 2018 in Non-Hodgkin lymphoma | 0 comments

In a nutshell

This study investigated the effectiveness, side effects, and relapse patterns of patients with low-grade (indolent; painless) follicular lymphoma (FL) or marginal zone lymphoma (MZL) after low-dose radiotherapy (LDRT). This study concluded that LDRT is an effective treatment in patients with low-grade disease and a low tumor burden.

Some background

LDRT is commonly used in patients with low-grade NHL. Compared to other solid tumors, NHLs are more sensitive to radiation. With a short treatment duration, low cost, and little to no side effects, LDRT is one alternative to conventional radiation therapy. For patients who relapse early or do not have good remission after LDRT, conventional radiation therapy may be needed. Close follow-up is important for these patients.

Extensive radiation treatment for low-grade NHL patients has increased time to relapse, but survival rates have not improved. 80% of patients show new disease outside of previously radiated areas. For these patients, whether LDRT improves outcomes is still under investigation.

Methods & findings

This study examined the records of 47 patients with low-grade FL (57.4%) or MZL (59.6%). Patients received LDRT as a first-line (60%) or second-line (40%) treatment. 81% of patients had early-stage disease (stage 1 or 2). All patients received LDRT. 26% of patients also received rituximab (Rituxan). The average follow-up period was 21 months.

The overall survival (OS; time from treatment until death from any cause) rate at 2 years was 96.6% for all patients. The OS at 5 years was 88.6% for all patients. 90% of all patients showed an overall response (OR; cancer shrinks or disappears after treatment). Of these, 82% had a complete response (CR; cancer disappears) and 8% had a partial response (PR; cancer shrinks). 90% of patients who received first-line LDRT and 80% of patients who received second-line LDRT showed a CR.

At an average of 6 months after treatment, 10.6% of patients relapsed. All of these patients achieved a CR after additional treatment. 14.9% of patients had disease progression outside of the radiation field (distant).

70% of reported side effects were due to the disease itself. 89% of these patients experienced symptom relief after LDRT treatment. None of the patients experienced skin rash or hair loss from LDRT.

The bottom line

This study concluded that LDRT is an effective first-line or second-line treatment for patients with low-grade NHL.

The fine print

The sample size in this study is quite small. More studies are needed to further confirm the results from this study. Also, because this study looked back in time to analyze patient data, the collected data may be incomplete. The follow-up time was also short (21 months).

What’s next?

If you have low-grade non-Hodgkin’s lymphoma at an early stage, talk to your care team about LDRT as a first-line or second-line treatment.

Published By :

Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft … [et al]

Date :

Feb 15, 2018

Original Title :

Response rates and recurrence patterns after low-dose radiotherapy with 4?Gy in patients with low-grade lymphomas.

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