Low dose palliative radiotherapy for refractory aggressive lymphoma.
OBJECTIVE
To determine the efficacy of low-dose palliative radiotherapy in patients with refractory aggressive lymphoma.


BACKGROUND
There are few reports on the administration of palliative radiotherapy to patients with aggressive lymphoma.


METHODS
The present study included 11 patients with 30 sites of aggressive lymphoma (diffuse large cell lymphoma, n = 7; mantle cell lymphoma, n = 2; follicular large cell lymphoma, n = 1; and peripheral T cell lymphoma, n = 1). The patients received local palliative radiotherapy after receiving a median of 4 chemotherapy regimens. The radiotherapy doses administered to the 30 sites were as follows: 8 Gy, single fraction (n = 27); 6 Gy, single fraction (n = 1); 4 Gy, single fraction (n = 1); and 4 Gy, 2 fractions (n = 1).


RESULTS
The complete response rate was 45% (5/11); the partial response rate was 36% (4/11). Toxicity occurred at one irradiated site (the mandibular), which showed temporal acute gingivitis; however, medication was not required. Retreatment was required for 3 sites on the head (parotid, face and mandible) due to persistent discomfort. None of the other sites (27/30) required retreatment. A patient with refractory DLBCL underwent radiotherapy (4 Gy, single fraction) for hepatic hilar lymph node involvement but did not recover from jaundice and died of DLBCL.


CONCLUSIONS
Eight Gray single fraction radiotherapy was one of meaningful options for the treatment of refractory aggressive lymphoma in terms of its efficacy and the incidence of adverse events. The use of 8 Gy single fraction radiotherapy is therefore recommended for achieving local control in patients with refractory aggressive lymphoma.
Department of Radiation Oncology, Gifu Municipal Hospital, 7-1 Kashima-cho, Gifu 500-8513, Japan.
Osamu
O
Tanaka
Department of Radiation Oncology, Cancer Institute Hospital, 3-8-31 Koto Ariake, Tokyo 135-8550, Japan.
Masahiko
M
Oguchi
Department of Radiation Oncology, Gifu Municipal Hospital, 7-1 Kashima-cho, Gifu 500-8513, Japan.
Takayoshi
T
Iida
Department of Hematology, Gifu Municipal Hospital, 7-1 Kashima-cho, Gifu 500-8513, Japan.
Senji
S
Kasahara
Department of Hematology, Gifu Municipal Hospital, 7-1 Kashima-cho, Gifu 500-8513, Japan.
Hideko
H
Goto
Department of Hematology, Gifu Municipal Hospital, 7-1 Kashima-cho, Gifu 500-8513, Japan.
Takeshi
T
Takahashi
Low dose radiotherapy; Palliation; Quality of life; Refractory lymphoma; Salvage