title: Long-term outcome and mortality trends in early-stage, Grade 1-2 follicular lymphoma treated with radiation therapy.
abstract: OBJECTIVE
  To analyze long-term outcomes and causes of death in patients receiving radiation therapy (RT) for localized, low-grade follicular lymphoma.
  
  
  METHODS
  Between 1972 and 2000, 106 patients with Stage I-II, Grade 1-2 follicular lymphoma received RT alone or radiation and chemotherapy (RT/CT). Seventy-four percent had Stage I, and 26% had Stage II disease. Seventy-six percent received RT alone, and 24% received combined RT/CT. Second malignancy rates were compared with an age- and sex-matched population.
  
  
  RESULTS
  Median follow-up was 12 years. Median survival time was 19 years. The 5-, 10-, and 15-year overall survival (OS) rates were 93%, 75%, and 62%, respectively. Age > or = 60 was the only significant adverse prognostic factor with respect to OS. There were 35 deaths, 20 of which were attributable to lymphoma. Freedom from treatment failure (FFTF) rates at 5, 10, and 15 years were 72%, 46%, and 39%, respectively. Forty-seven patients (48%) relapsed. Tumor size > 3 cm was the only significant adverse factor for FFTF. Observed incidence of second malignancy did not significantly exceed expected incidence.
  
  
  CONCLUSIONS
  Although patients with early-stage, low-grade follicular lymphoma have long median survival, the leading cause of death remains lymphoma. However, patients receiving RT do not have significantly elevated cumulative incidence of second malignancy.
authors.affiliation: Joint Center for Radiation Therapy/Harvard Radiation Oncology Residency Program, Boston, MA, USA. aguadagnolo@lroc.harvard.edu
authors.forename: Beverly A
authors.initials: BA
authors.lastname: Guadagnolo
authors.forename: Sigui
authors.initials: S
authors.lastname: Li
authors.forename: Donna
authors.initials: D
authors.lastname: Neuberg
authors.forename: Andrea
authors.initials: A
authors.lastname: Ng
authors.forename: Ling
authors.initials: L
authors.lastname: Hua
authors.forename: Barbara
authors.initials: B
authors.lastname: Silver
authors.forename: Mary Ann
authors.initials: MA
authors.lastname: Stevenson
authors.forename: Peter
authors.initials: P
authors.lastname: Mauch
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008224:Lymphoma, Follicular / Q000188:drug therapy / Q000401:mortality* / Q000473:pathology / Q000532:radiotherapy*; D008228:Lymphoma, Non-Hodgkin / Q000188:drug therapy / Q000401:mortality* / Q000473:pathology / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000639:trends; D009367:Neoplasm Staging; D016609:Neoplasms, Second Primary / Q000453:epidemiology; D016896:Treatment Outcome