title: The role of radiotherapy in the treatment of localised intermediate and high grade non-Hodgkin's lymphoma in elderly patients.
abstract: OBJECTIVE
  The treatment of elderly patients with high or intermediate grade non-Hodgkin's lymphoma (NHL) remains difficult and controversial. In order to audit our own practice, 270 elderly patients treated between 1988 and 1993 with this diagnosis were retrospectively reviewed.
  
  
  METHODS
  81 patients unfit for chemotherapy received fractionated radiotherapy for apparently localised stage I or II disease. The median age of the patients was 78 years (range 70-87 years). Forty stage I and 17 stage II patients had extra-nodal sites of disease. The radiation field included the primary site plus immediate adjacent nodes.
  
  
  RESULTS
  After a median follow-up of 3.9 years the 5-year overall and disease-free survival rates were 33% and 31%, respectively. Age (hazard ratio (HR) 1.22, P = 0.03), stage (HR 5.50, P = 0.02) and lactate dehydrogenase level (HR 1.003, P = 0.004) were identified as independent risk factors for relapse.
  
  
  CONCLUSIONS
  These factors can define a group in which radiotherapy can produce acceptable survival rates (age < or = 80 years, stage I and lactate dehydrogenase < or = 500). This group represented 34% of those patients where all these variables were recorded and had 5-year disease-free and overall survival rates of 56% and 62%, respectively.
authors.affiliation: Department of Clinical Oncology, Christie Hospital NHS Trust, Withington, Manchester, UK.
authors.forename: J P
authors.initials: JP
authors.lastname: Wylie
authors.forename: R A
authors.initials: RA
authors.lastname: Cowan
authors.forename: D P
authors.initials: DP
authors.lastname: Deakin
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000401:mortality / Q000532:radiotherapy*; D008297:Male; D015996:Survival Rate