title: Effect of radiotherapy on the survival of patients with stage I and stage II mantle cell lymphoma: analysis of the Surveillance, Epidemiology and End Results database.
abstract: BACKGROUND
  Radiotherapy is a treatment option for stage I and stage II MCL. However, data demonstrating the role of RT in a larger patient population and its real world effects are unknown.
  
  
  METHODS
  To demonstrate the role of RT in the OS of patients with stage I and stage II MCL, we performed a retrospective analysis of the SEER database. Included patients were adults with age > 40 years who had MCL stages I and II, and diagnosis between 1992 and 2010. We excluded patients lacking information on demographic characteristics, survival, and RT. Patients were analyzed in 2 groups, those treated with initial RT (RT group) and those not treated with initial RT (no-RT group).
  
  
  RESULTS
  A total of 657 patients were eligible for analysis with 178 patients in the RT group and 479 patients in the no-RT group. The median age of the study group was 68 years. The RT group had a significantly greater proportion of patients with age < 60, male sex, and extranodal disease. Median OS was 103 months in the RT group versus 66 months in the no-RT group (P = .002). On Multivariate analysis, treatment with initial RT was associated with a lower hazard for mortality (hazard ratio, 0.767; 95% confidence interval, 0.602-0.979; P = .033). Age < 60, stage I disease, and extranodal disease were independently associated with a significantly decreased hazard for mortality on Multivariate analysis.
  
  
  CONCLUSIONS
  Although stage I and stage II MCL constitute only a small proportion of this disease, our study demonstrates that upfront RT improves the OS of these patients.
authors.affiliation: Division of Internal Medicine, University of Arkansas for Medical Sciences, Little Rock, AR. Electronic address: drguru07@gmail.com.
authors.forename: Guru Subramanian
authors.initials: GS
authors.lastname: Guru Murthy
authors.affiliation: Cochin Medical College, Kochi, India.
authors.forename: Raji
authors.initials: R
authors.lastname: Venkitachalam
authors.affiliation: Division of Hematology/Oncology, University of Arkansas for Medical Sciences and Central Arkansas Veterans Health System, Little Rock, AR.
authors.forename: Paulette
authors.initials: P
authors.lastname: Mehta
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D020522:Lymphoma, Mantle-Cell / Q000453:epidemiology / Q000401:mortality* / Q000473:pathology / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011159:Population Surveillance; D012189:Retrospective Studies; D018426:SEER Program; D016896:Treatment Outcome
keywords: Adults; B-cell non-Hodgkin lymphoma; Cyclin D1; Radiation; t(11,14)(q13;q32)