Value of radiation therapy in the management of chemoresistant intermediate grade non-Hodgkin's lymphoma.

A Aref, S Narayan, S Tekyi-Mensah, M Varterasian, M Dan, D Eilender, C Karanes, A al-Katib
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引用次数: 22

Abstract

The purpose of this study was to evaluate the probability and extent of response to radiation therapy in patients with chemotherapy-resistant intermediate grade non-Hodgkin's lymphoma. Thirty-five patients with chemotherapy-resistant non-Hodgkin's lymphoma received local radiation therapy after initial treatment with at least six cycles of systemic chemotherapy. There were 17 men and 18 women in our study. Ages ranged from 15 to 68 years, median age was 42 years. Chemotherapy resistance was defined as relapse after initial chemotherapy (11 patients) or failure to achieve complete remission (partial response in 18 patients, stable disease in 1 patient, and disease progression in 5 patients). Radiation doses were between 1,980-5,040 cGy (median dose of 3,200 cGy). Treatment outcome was evaluated with respect to any subsequent relapse either within or outside the irradiated region. The 2-year actuarial survival was 65%. The cumulative incidence of isolated local failure and any local failure at 2 years were 33% and 54%, respectively. Tumors that responded to initial chemotherapy had a better local control probability than tumors that did not respond. The 2-year actuarial local failure rates for these two groups were 51% and 83%, respectively (P = 0.01). There was a trend for improved local control with radiation doses > or = 3,960 cGy, suggesting the presence of a dose-control relationship. The rate of disease progression within an irradiated region in patients with intermediate grade non-Hodgkin's lymphoma that relapsed after or failed to respond completely to full course chemotherapy was substantially higher than the historical in-field failure rates when radiation therapy was used as the sole modality of treatment. Prior response to initial chemotherapy was a predicting factor for local control following radiation therapy.

放射治疗在化疗耐药中级非霍奇金淋巴瘤治疗中的价值。
本研究的目的是评估化疗耐药的中度非霍奇金淋巴瘤患者放射治疗反应的可能性和程度。35例化疗耐药的非霍奇金淋巴瘤患者在初始治疗后接受了至少6个周期的全身化疗后的局部放疗。在我们的研究中有17名男性和18名女性。年龄15 ~ 68岁,中位年龄42岁。化疗耐药定义为初始化疗后复发(11例)或未能达到完全缓解(18例部分缓解,1例病情稳定,5例病情进展)。辐射剂量在1980 -5,040 cGy之间(中位剂量为3,200 cGy)。治疗结果被评估在放疗区域内或照射区域外的任何后续复发。2年精算生存率为65%。2年孤立性局部失败和任何局部失败的累积发生率分别为33%和54%。对初始化疗有反应的肿瘤比无反应的肿瘤有更好的局部控制概率。两组2年精算局部失败率分别为51%和83% (P = 0.01)。当辐射剂量>或= 3,960 cGy时,有改善局部控制的趋势,表明存在剂量-控制关系。当使用放射治疗作为唯一治疗方式时,中等级别非霍奇金淋巴瘤患者在全疗程化疗后复发或未能完全响应的放射区域内疾病进展率大大高于历史上的现场失败率。先前对初始化疗的反应是放疗后局部控制的预测因素。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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