title: Reduction of the treated volume to involved node radiation therapy as part of combined modality treatment for early stage aggressive non-Hodgkin's lymphoma.
abstract: OBJECTIVE
  This retrospective study investigated whether focused involved node radiation therapy (INRT) can safely replace involved field RT (IFRT) in patients with early stage aggressive NHL.
  
  
  METHODS
  We included 258 patients with stage I/II aggressive NHL who received combined modality treatment (87%) or primary RT alone (13%). RT consisted of a total dose of 30-40 Gy in 15-20 fractions IFRT or INRT. We compared survival, relapse pattern, radiation-related toxicity and quality of life for both RT techniques.
  
  
  RESULTS
  Type of RT was not related to the outcome in either the uni- or multivariate survival analysis. Relapses developed in 59 of 252 patients (23%) of which 47 (80%) were documented as distant recurrence only. Failure of the INRT technique was noted in one patient. There was no significant difference in acute radiation-related toxicity between RT-groups but IFRT showed a significantly higher incidence of higher grade toxicities. Patients treated with INRT had a significantly better physical functioning and global quality of life compared to the IFRT group.
  
  
  CONCLUSIONS
  Given the retrospective nature of this study, no solid conclusions can be drawn. However, in view of the equivalent efficacy and more favorable toxicity profile, the replacement of IFRT by INRT in combination with chemo-(immuno)-therapy looks very attractive for patients with early stage aggressive NHL.
authors.affiliation: Department of Radiation Oncology, Institute Verbeeten, Tilburg, The Netherlands.
authors.forename: Marieke H
authors.initials: MH
authors.lastname: Verhappen
authors.forename: Philip M P
authors.initials: PM
authors.lastname: Poortmans
authors.forename: Esther
authors.initials: E
authors.lastname: Raaijmakers
authors.forename: John M M
authors.initials: JM
authors.lastname: Raemaekers
mesh_terms: D000328:Adult; D000368:Aged; D003131:Combined Modality Therapy; D005260:Female; D006321:Heart / Q000528:radiation effects; D006801:Humans; D008198:Lymph Nodes / Q000528:radiation effects*; D008228:Lymphoma, Non-Hodgkin / Q000473:pathology / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D012189:Retrospective Studies
keywords: Chemotherapy; Involved field radiation therapy; Involved node radiation therapy; Malignant lymphoma; Non-Hodgkin’s lymphoma