title: The long term follow-up of early stage follicular lymphoma treated with radiotherapy, chemotherapy or combined modality treatment.
abstract: Local (involved-field or recently involved-site) radiotherapy is the standard therapy in limited-stage follicular lymphoma (FL). We retrospectively analyzed the value of chemotherapy in 130 patients with limited-stage FL (46 treated with radiotherapy alone [RT group], 30 with radiotherapy plus chemotherapy [COMBINED group] and 43 with chemotherapy alone [CHEMO group], 11 were managed with observation). Ninety-six percent of patients responded (RT 98%, COMBINED 100%, CHEMO 91%, p=0.179), and 37% (40/107) of patients in complete response relapsed (RT 42%, COMBINED 27%, CHEMO 41%, p=0.371). Progression-free survival (PFS) and overall survival (OS) probabilities at 10 years were similar in RT, COMBINED and CHEMO patients (PFS 41%, 61% and 39% [p=0.167], and OS 77%, 81% and 72% [p=0.821], respectively), while the COMBINED group showed a trend to better time-to-progression (TTP 43%, 72% and 47% [p=0.055]). On multivariate analysis, only a FLIPI score ≥2 showed a trend to influence PFS (HR 2.1 [95% confidence interval 0.9-4.6], p=0.067), and OS (HR 2.4 [0.9-6.5], p=0.084), while patients treated with radiotherapy plus chemotherapy (COMBINED group) showed a significantly better TTP compared with those receiving only RT (HR 0.3 [0.1-0.8], p=0.024). In our study no benefit was observed in survival with the use of systemic therapy compared with local radiotherapy.
authors.affiliation: Hematology Departments of ICO-Hospital Germans Trias i Pujol, Jose Carreras Research Institute, Badalona, Universitat Autònoma de Barcelona, Spain. Electronic address: jsancho@iconcologia.net.
authors.forename: Juan-Manuel
authors.initials: JM
authors.lastname: Sancho
authors.affiliation: Hematology Departments of ICO-Hospital Germans Trias i Pujol, Jose Carreras Research Institute, Badalona, Universitat Autònoma de Barcelona, Spain.
authors.forename: Olga
authors.initials: O
authors.lastname: García
authors.affiliation: ICO-Hospital Duran i Reynals, Barcelona, Spain.
authors.forename: Santiago
authors.initials: S
authors.lastname: Mercadal
authors.affiliation: ICO-Hospital Duran i Reynals, Barcelona, Spain.
authors.forename: Helena
authors.initials: H
authors.lastname: Pomares
authors.affiliation: Hospital de Cabueñes, Gijón, Spain.
authors.forename: Rubén
authors.initials: R
authors.lastname: Fernández-Alvarez
authors.affiliation: ICO-Hospital Duran i Reynals, Barcelona, Spain.
authors.forename: Eva
authors.initials: E
authors.lastname: González-Barca
authors.affiliation: Pathology Department, Hospital Germans Trias i Pujol, Spain.
authors.forename: Gustavo
authors.initials: G
authors.lastname: Tapia
authors.affiliation: Hospital de Cabueñes, Gijón, Spain.
authors.forename: Esther
authors.initials: E
authors.lastname: González-García
authors.affiliation: Hematology Departments of ICO-Hospital Germans Trias i Pujol, Jose Carreras Research Institute, Badalona, Universitat Autònoma de Barcelona, Spain.
authors.forename: Miriam
authors.initials: M
authors.lastname: Moreno
authors.affiliation: ICO-Hospital Duran i Reynals, Barcelona, Spain.
authors.forename: Eva
authors.initials: E
authors.lastname: Domingo-Domènech
authors.affiliation: Hematology Departments of ICO-Hospital Germans Trias i Pujol, Jose Carreras Research Institute, Badalona, Universitat Autònoma de Barcelona, Spain.
authors.forename: Marc
authors.initials: M
authors.lastname: Sorigué
authors.affiliation: Hematology Departments of ICO-Hospital Germans Trias i Pujol, Jose Carreras Research Institute, Badalona, Universitat Autònoma de Barcelona, Spain.
authors.forename: José-Tomás
authors.initials: JT
authors.lastname: Navarro
authors.affiliation: Hematology Departments of ICO-Hospital Germans Trias i Pujol, Jose Carreras Research Institute, Badalona, Universitat Autònoma de Barcelona, Spain.
authors.forename: Cristina
authors.initials: C
authors.lastname: Motlló
authors.affiliation: ICO-Hospital Duran i Reynals, Barcelona, Spain.
authors.forename: Alberto
authors.initials: A
authors.lastname: Fernández-de-Sevilla
authors.affiliation: Hematology Departments of ICO-Hospital Germans Trias i Pujol, Jose Carreras Research Institute, Badalona, Universitat Autònoma de Barcelona, Spain.
authors.forename: Evarist
authors.initials: E
authors.lastname: Feliu
authors.affiliation: Hematology Departments of ICO-Hospital Germans Trias i Pujol, Jose Carreras Research Institute, Badalona, Universitat Autònoma de Barcelona, Spain.
authors.forename: Josep-Maria
authors.initials: JM
authors.lastname: Ribera
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D003131:Combined Modality Therapy / Q000706:statistics & numerical data; D004358:Drug Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008224:Lymphoma, Follicular / Q000401:mortality* / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011878:Radiotherapy / Q000706:statistics & numerical data; D016019:Survival Analysis; D055815:Young Adult
keywords: Chemotherapy; Follicular lymphoma; Limited stage; Radiotherapy