[Analysis of in-field and marginal relapse in stage I/II non-Hodgkin's lymphoma treated with radiotherapy].
One hundred sixty-three patients with previously untreated stage I/II non-Hodgkin's lymphoma were analyzed as to their in-field and marginal relapse of the irradiated field following treatment with more than 30 Gy of radiotherapy between 1981 and 1995 at Hyogo Medical Center for Adults. Local regrowth in case of partial response was counted as in-field relapse. Complete response was obtained in 94.5% of the cases at the termination of radiotherapy and in 98.8% finally. The ten-year cumulative in-field relapse and marginal relapse rates were 5% and 8.7%, respectively. The cumulative in-field relapse rate (CIFRR) in cases of bulky disease (more than 5 cm in largest diameter of the tumor) was significantly higher than in those of non-bulky disease (26.1% in 8 years vs 2.4% in 10 years, P < 0.01). The radiation dosage delivered (40 Gy = < and 50 Gy > vs 50 Gy < =) a great much difference in cases of bulky disease (23.8% for 8-year CIFRR vs 0% for 1-year CIFRR, respectively), but less difference with non-bulky disease (2.6% vs 2.2%). High LDH and suboptimal dose chemotherapy (three courses and less chemotherapy containing ADM or its derivatives, chemotherapy without ADM or no chemotherapy) had a negative impact on marginal control in aggressive lymphoma. Extended field setting in aggressive lymphoma was not proven to be beneficial in comparison with involved field setting as to marginal field relapse. Thus, it is concluded that (1) higher doses should be given to bulky disease, (2) careful field coverage with enough margin is recommended for aggressive lymphoma with high LDH or treated without optimal dose chemotherapy, and (3) extended field setting is not necessary.
Hirota
S
S
Department of Radiology, Hyogo Medical Center for Adults.
Soejima
T
T
Tsurusaki
M
M
Obayashi
K
K
Takada
Y
Y
Hishikawa
Y
Y
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000188:drug therapy / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D011879:Radiotherapy Dosage; D016896:Treatment Outcome