title: Radiotherapy for stage I/II follicular lymphoma (FL): is it time for a re-appraisal?
abstract: OBJECTIVE
  Almost 30% of follicular lymphomas (FL) present with stage I-II disease. Although the standard-of-care consists of involved-field radiotherapy (IFRT), approximately half of patients relapse usually outside the primary irradiation field. Systemic immunotherapy with rituximab (R), with or without IFRT, could reduce distant recurrences leading to a better outcome. Therefore, we compared the efficacy of IFRT-alone or associated with R (R+IFRT) versus R-alone in stage I/II FL (grade 1-3A).
  
  
  METHODS
  From 1995 to September 2012, 108 early-stage FL patients were retrospectively assessed: 36 underwent IFRT, 38 R-alone and 34 R+IFRT.
  
  
  RESULTS
  Complete response rate was 84% in the IFRT-group, 87% in the R group and 97% in the R+IFRT-group. Median progression-free survival and time to next treatment were significantly higher in both rituximab arms compared to IFRT-alone.
  
  
  CONCLUSIONS
  R or R+IFRT have demonstrated a better long-term control of the disease without significant additional toxicities.
authors.affiliation: Department of Human Pathology, University of Messina, Messina, Italy patriziamondello@hotmail.it.
authors.forename: Patrizia
authors.initials: P
authors.lastname: Mondello
authors.affiliation: Department of Hematology & Oncology, Medical University of Innsbruck, Innsbruck, Austria.
authors.forename: Normann
authors.initials: N
authors.lastname: Steiner
authors.affiliation: Department of Internal Medicine, Hospital of Feldkirch, Feldkirch, Austria.
authors.forename: Ines
authors.initials: I
authors.lastname: Wasle
authors.affiliation: Department of Human Pathology, University of Messina, Messina, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Pitini
authors.affiliation: Department of Hematology & Oncology, Medical University of Innsbruck, Innsbruck, Austria Department of Hematology, Azienda Ospedaliera S. Maurizio, Bolzano, Italy.
authors.forename: Michael
authors.initials: M
authors.lastname: Mian
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008224:Lymphoma, Follicular / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D011379:Prognosis; D011879:Radiotherapy Dosage; D012189:Retrospective Studies; D015996:Survival Rate
keywords: Early stage; follicular lymphoma; radiotherapy; rituximab