Single institute experience of chemotherapy and adjuvant radiotherapy for localized aggressive non-Hodgkin's lymphoma: retrospective analysis of the clinical efficacy of radiation therapy.
We retrospectively analyzed the clinical outcome of localized aggressive lymphoma treated with chemotherapy and adjuvant radiotherapy. Between 1982 and 1998, 77 patients who were diagnosed as having aggressive lymphoma stage I-II were treated with chemotherapy followed by radiation therapy. The median radiation dose was 44.4 Gy (range, 30-64 Gy). Some patients who achieved complete response after chemotherapy received limited-field radiation to reduce toxicity. Several prognostic factors were analyzed in the overall (OAS) and relapse-free survival (RFS) by both uni- and multivariate analysis. The 5-year rates of OAS and RFS were 74.6% and 70.8%, respectively. Patient age (p = 0.016), radiation dose (p = 0.043), and prognostic score proposed by the Japan Lymphoma Radiation Therapy Group (JLRTG; p = 0.0073) were significant predictive factors for OAS. As for RFS, predictive factors were patient age (p = 0.042), elevated level of serum lactic dehydrogenase (p = 0.046), and JLRTG score (p = 0.05). At the multivariate level, only patient age greater than 60 years was a significantly adverse variable for both OAS (p = 0.0079) and RFS (p = 0.0198). Our treatment strategy was thought to be acceptable with satisfactory outcomes. Limited-field radiation may have possible advantages in toxicity if it does not lead to worsening of the outcome, although a conclusive result could not be obtained by the current analysis.
Kodaira
Takeshi
T
Department of Radiation Oncology, Aichi Cancer Center, Nagoya, Aichi, Japan.
Fuwa
Nobukazu
N
Kamata
Minoru
M
Furutani
Kazuhisa
K
Ogura
Michinori
M
Morishima
Yasuo
Y
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000188:drug therapy / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D011879:Radiotherapy Dosage; D018714:Radiotherapy, Adjuvant; D012074:Remission Induction; D012189:Retrospective Studies; D016019:Survival Analysis