Radiation Therapy for Primary Cutaneous Anaplastic Large Cell Lymphoma: An International Lymphoma Radiation Oncology Group Multi-institutional Experience.
To collect response rates of primary cutaneous anaplastic large cell lymphoma, a rare cutaneous T-cell lymphoma, to radiation therapy (RT), and to determine potential prognostic factors predictive of outcome.



The study was a retrospective analysis of patients with primary cutaneous anaplastic large cell lymphoma who received RT as primary therapy or after surgical excision. Data collected include initial stage of disease, RT modality (electron/photon), total dose, fractionation, response to treatment, and local recurrence. Radiation therapy was delivered at 8 participating International Lymphoma Radiation Oncology Group institutions worldwide.



Fifty-six patients met the eligibility criteria, and 63 tumors were treated: head and neck (27%), trunk (14%), upper extremities (27%), and lower extremities (32%). Median tumor size was 2.25 cm (range, 0.6-12 cm). T classification included T1, 40 patients (71%); T2, 12 patients (21%); and T3, 4 patients (7%). The median radiation dose was 35 Gy (range, 6-45 Gy). Complete clinical response (CCR) was achieved in 60 of 63 tumors (95%) and partial response in 3 tumors (5%). After CCR, 1 tumor recurred locally (1.7%) after 36 Gy and 7 months after RT. This was the only patient to die of disease.



Primary cutaneous anaplastic large cell lymphoma is a rare, indolent cutaneous lymphoma with a low death rate. This analysis, which was restricted to patients selected for treatment with radiation, indicates that achieving CCR was independent of radiation dose. Because there were too few failures (<2%) for statistical analysis on dose response, 30 Gy seems to be adequate for local control, and even lower doses may suffice.
Stanford Cancer Institute, Stanford, California. Electronic address: lmillion@stanford.edu.
Lynn
L
Million
Stanford Cancer Institute, Stanford, California.
Esther J
EJ
Yi
Stanford Cancer Institute, Stanford, California.
Frank
F
Wu
Stanford Cancer Institute, Stanford, California.
Rie
R
Von Eyben
Department of Radiation Oncology and Cancer Imaging, Peter MacCallum Cancer Centre, East Melbourne, Australia.
Belinda A
BA
Campbell
The University of Texas MD Anderson Cancer Center, Houston, Texas.
Bouthaina
B
Dabaja
Department of Radiation Oncology, Princess Margaret Cancer Centre, Toronto, Ontario, Canada.
Richard W
RW
Tsang
Department of Radiation Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts.
Andrea
A
Ng
Department of Therapeutic Radiology/Radiation Oncology, Yale School of Medicine, Yale Cancer Center, New Haven, Connecticut.
Lynn D
LD
Wilson
Department of Oncology, University of Turin, Turin, Italy.
Umberto
U
Ricardi
Institut Curie, Paris, France.
Youlia
Y
Kirova
Stanford Cancer Institute, Stanford, California.
Richard T
RT
Hoppe
D000328:Adult; D000368:Aged; D019583:Dose Fractionation, Radiation; D019317:Evidence-Based Medicine; D005260:Female; D006801:Humans; D038622:Internationality; D017728:Lymphoma, Large-Cell, Anaplastic / Q000175:diagnosis* / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000517:prevention & control*; D020266:Radiotherapy, Conformal / Q000379:methods*; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000175:diagnosis* / Q000532:radiotherapy*; D015996:Survival Rate; D016896:Treatment Outcome