Relapse patterns of localized non-Hodgkin's lymphoma of the head and neck after clinical remission: results of a strict follow-up procedure.
BACKGROUND
No effective follow-up strategy for non-Hodgkin's lymphoma (NHL) has been identified to date. The aim of this study was to assess the value of a strict follow-up procedure in patients with NHL after they showed clinical remission.


METHODS
One hundred and twenty-one patients with localized NHL of the head and neck who had achieved clinical remission after radiation therapy and/or chemotherapy were followed with a strict follow-up strategy (consisting of a schedule of frequent office visits, imaging studies, and blood tests, even if the patient was asymptomatic).


RESULTS
Thirty-nine patients relapsed after remission. Twenty-two (56.4%) of the relapses were associated with symptoms. In the 17 patients with asymptomatic relapses (43.6%), an abnormal physical examination result initially indicated relapse in 10 patients. The other tests that initially indicated relapse included scheduled computed tomography scans (3 patients), scheduled gallium scans (2 patients), and serum lactate dehydrogenase levels (2 patients). According to the Ann Arbor stage at relapse, 72.7% of the patients with symptomatic relapses were stage III or IV, while 70.6% of the patients with asymptomatic relapses were stage I or II.


CONCLUSIONS
These results indicate that a strict follow-up procedure is effective in detecting asymptomatic relapses, which generally involve a smaller tumor load than symptomatic relapses.
Nakamura
K
K
Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan. nakam@radiol.med.kyushu-u.ac.jp
Sasaki
M
M
Kunitake
N
N
Kimura
M
M
Watanabe
T
T
Sasaki
T
T
Terashima
H
H
Kuwabara
Y
Y
Sakai
S
S
Masuda
K
K
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D016026:Bone Marrow Transplantation; D002493:Central Nervous System Diseases / Q000139:chemically induced; D005260:Female; D005708:Gallium; D006258:Head and Neck Neoplasms / Q000473:pathology* / Q000628:therapy; D006801:Humans; D007770:L-Lactate Dehydrogenase / Q000097:blood; D008228:Lymphoma, Non-Hodgkin / Q000473:pathology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology*; D009367:Neoplasm Staging; D010808:Physical Examination; D012074:Remission Induction; D013997:Time Factors; D014057:Tomography, X-Ray Computed
D005708:Gallium; D007770:L-Lactate Dehydrogenase