title: Complete long-term response to radiotherapy of gastric early-stage marginal zone lymphoma resistant to both anti-Helicobacter pylori antibiotics and chemotherapy.
abstract: BACKGROUND
  The optimal approach to patients with gastric lymphoma of extranodal mucosa-associated lymphoid tissue (MALT) that resist to anti-Helicobacter pylori (HP) eradication therapy is still to be defined.
  
  
  METHODS
  From January 1997 to December 2004, we observed 24 patients affected with newly diagnosed early-stage and HP-positive gastric lymphoma of the MALT type. Five of them resisted to oral anti-HP antibiotic regimens and to subsequent one (two patients) or two (three patients) chemotherapy regimens. Age ranged between 51 and 77 years (median 70); three were females. Translocation (11;18) was ascertained in one subject. They were admitted to local radiation therapy with a total dose of 30 Gy.
  
  
  RESULTS
  All such resistant patients achieved complete remission after radiotherapy. No relapses were observed after 21, 45, 48, 52, and 67 months of uninterrupted follow-up. Early toxicity was very low and consisted of mild nausea. Late toxicity or secondary malignancy was not recorded so far.
  
  
  CONCLUSIONS
  Radiotherapy proved to be effective and safe for early-stage HP-positive gastric extranodal lymphoma of MALT type that is resistant to anti-HP eradication antibiotics and to following chemotherapy. Radiotherapy might be suggested as principal salvage therapy after resistance to HP eradication, instead of chemotherapy.
authors.affiliation: Clinica Medica I, Università di Pavia and Servizio di Radioterapia Oncologica, Pavia, Italy. gobbipg@smatteo.pv.it
authors.forename: P G
authors.initials: PG
authors.lastname: Gobbi
authors.forename: F
authors.initials: F
authors.lastname: Corbella
authors.forename: F
authors.initials: F
authors.lastname: Valentino
authors.forename: M
authors.initials: M
authors.lastname: Bergonzi
authors.forename: C
authors.initials: C
authors.lastname: Sangalli
authors.forename: V
authors.initials: V
authors.lastname: Perfetti
authors.forename: G R
authors.initials: GR
authors.lastname: Corazza
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D019008:Drug Resistance, Neoplasm; D005260:Female; D016480:Helicobacter pylori / Q000187:drug effects*; D006801:Humans; D018442:Lymphoma, B-Cell, Marginal Zone / Q000188:drug therapy / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D012074:Remission Induction; D013274:Stomach Neoplasms / Q000188:drug therapy / Q000532:radiotherapy*
chemical_list: D000900:Anti-Bacterial Agents; D000970:Antineoplastic Agents