title: Exclusive moderate-dose radiotherapy in gastric marginal zone B-cell MALT lymphoma: Results of a prospective study with a long term follow-up.
abstract: BACKGROUND
  In gastric MALT lymphomas persisting after Helicobacter pylori (H. pylori) eradication, a treatment by moderate-dose radiotherapy (RT) has been proposed but its efficacy has not been confirmed in large prospective series with long term endoscopic follow-up.
  
  
  METHODS
  Patients with localised gastric MALT lymphoma persisting after H. pylori eradication were offered moderate-dose RT (30Gy, 2Gy/fraction) and followed with annual endoscopies. All biopsies before and after RT were reviewed by a committee of pathologists.
  
  
  RESULTS
  From 1995 to 2011, out of the 232 patients followed prospectively, 53 received RT for persistence of lymphoma after H. pylori eradication: either macroscopic ulcer (n=31), or microscopic lymphomatous infiltrate (n=22), after a mean follow-up of 12 and 31months, respectively. All lymphomas were localised (45 stage IE and 8 stage IIE) and 38 (72%) were H. pylori-positive. The mean clinical and endoscopic follow-up from diagnosis was 7.6years (2.2-19.1). No acute or late toxicity occurred. A complete remission was achieved in all patients but one (98%) with no relapse after a median follow-up of 4.9years (1.3-16.6) after completion of RT. Overall survival and 5-year disease specific survival were 94% and 100%, respectively. One patient died of gastric adenocarcinoma.
  
  
  CONCLUSIONS
  Moderate-dose RT (30Gy) is effective and safe for localised gastric MALT lymphoma persisting after H. pylori eradication.
authors.affiliation: Department of Gastroenterology, St Antoine Hospital, AP-HP, Faculté de Médicine Pierre et Marie Curie, Paris, France; Fédération Francophone de Cancérologie Digestive (FFCD), Dijon, France. Electronic address: agnes.fourmestraux@sat.aphp.fr.
authors.forename: Agnès
authors.initials: A
authors.lastname: Ruskoné-Fourmestraux
authors.affiliation: IMAD & Hepato-Gastroenterology and Digestive Oncology, CHU de Nantes, France; Fédération Francophone de Cancérologie Digestive (FFCD), Dijon, France.
authors.forename: Tamara
authors.initials: T
authors.lastname: Matysiak-Budnik
authors.affiliation: Department of Pathology, St Antoine Hospital, AP-HP, Faculté de Médecine Pierre et Marie Curie, Paris, France.
authors.forename: Bettina
authors.initials: B
authors.lastname: Fabiani
authors.affiliation: Department of Pathology, St Antoine Hospital, AP-HP, Faculté de Médecine Pierre et Marie Curie, Paris, France.
authors.forename: Pascale
authors.initials: P
authors.lastname: Cervera
authors.affiliation: Department of Gastroenterology, CHU Reims, France; Fédération Francophone de Cancérologie Digestive (FFCD), Dijon, France.
authors.forename: Hedia
authors.initials: H
authors.lastname: Brixi
authors.affiliation: Fédération Francophone de Cancérologie Digestive (FFCD), Dijon, France.
authors.forename: Karine
authors.initials: K
authors.lastname: Le Malicot
authors.affiliation: Department of Gastroenterology, St Antoine Hospital, AP-HP, Faculté de Médicine Pierre et Marie Curie, Paris, France.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Nion-Larmurier
authors.affiliation: Department of Pathology, St Antoine Hospital, AP-HP, Faculté de Médecine Pierre et Marie Curie, Paris, France.
authors.forename: Jean-Fançois
authors.initials: JF
authors.lastname: Fléjou
authors.affiliation: Department of Radiotherapy, St Louis Hospital, AP-HP, Paris, France; Fédération Francophone de Cancérologie Digestive (FFCD), Dijon, France.
authors.forename: Christophe
authors.initials: C
authors.lastname: Hennequin
authors.affiliation: Department of Radiotherapy, St Louis Hospital, AP-HP, Paris, France; Fédération Francophone de Cancérologie Digestive (FFCD), Dijon, France.
authors.forename: Laurent
authors.initials: L
authors.lastname: Quéro
mesh_terms: D000328:Adult; D000368:Aged; D001706:Biopsy; D005260:Female; D005500:Follow-Up Studies; D016481:Helicobacter Infections / Q000150:complications; D016480:Helicobacter pylori / Q000302:isolation & purification; D006801:Humans; D053208:Kaplan-Meier Estimate; D018442:Lymphoma, B-Cell, Marginal Zone / Q000382:microbiology / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011879:Radiotherapy Dosage; D012074:Remission Induction; D013274:Stomach Neoplasms / Q000382:microbiology / Q000532:radiotherapy*
keywords: Gastric MALT lymphoma; Helicobacter pylori; Prognosis; Radiotherapy; Treatment