title: Low-dose radiotherapy in diffuse large B-cell lymphoma.
abstract: Low-dose radiotherapy (LDRT) given in 2 × 2 Gy is a highly effective and safe treatment for palliation of indolent lymphomas. Otherwise, very little regarding the use of LDRT for diffuse large B-cell lymphoma (DLBCL) has been investigated. We designed a phase 2 trial of LDRT in patients with DLBCL with indication for palliative radiation. Low-dose radiotherapy was administered on symptomatic areas only. Clinical response was assessed 21 days after LDRT and defined as reduction >50% of maximum diameter of the radiated lesions. Quality of life was scored by the European Organisation for Research and Treatment of Cancer QLQ-C30 questionnaire. Tumor subtype (germinal center B-cell type versus activated B-cell type) and the presence of TP53 mutations in pathologic specimens of the target lesion were also evaluated. Twenty-three of twenty-five radiated patients were evaluable for response, and 2 died of disease before the visit at 21 days. The overall response rate was 70% (16 of 23 patients), with 7 complete responses and 9 partial responses (mean duration of response, 6 months; range, 1-39 months). Fifteen patients answered to the QLQ-C30 questionnaires, and an improved quality of life was documented in 9 cases. TP53 mutations were detected in 2 of 6 (33%) nonresponders and in none of the responders (P = .12). Germinal center B-cell type responded better than activated B-cell type (response rate was 83% and 29%, respectively, P = .01). These findings indicate that LDRT is effective for palliation in patients with DLBCL.
authors: Department of Radiation Oncology, Centro di Riferimento Oncologico (CRO), National Cancer Institute, Aviano, Italy.
authors: Carlo
authors: C
authors: Furlan
authors: Division of Pathology, Centro di Riferimento Oncologico (CRO), National Cancer Institute, Aviano, Italy.
authors: Vincenzo
authors: V
authors: Canzonieri
authors: Division of Medical Oncology A, Centro di Riferimento Oncologico (CRO), National Cancer Institute, Aviano, Italy.
authors: Michele
authors: M
authors: Spina
authors: Unit of Cell Therapy and High Dose Chemotherapy, Centro di Riferimento Oncologico (CRO), National Cancer Institute, Aviano, Italy.
authors: Mariagrazia
authors: M
authors: Michieli
authors: Second Division of Medicine, Azienda Ospedaliera Santa Maria degli Angeli, Pordenone, Italy.
authors: Anna
authors: A
authors: Ermacora
authors: Experimental Oncology 1, Centro di Riferimento Oncologico (CRO), National Cancer Institute, Aviano, Italy.
authors: Roberta
authors: R
authors: Maestro
authors: Experimental Oncology 1, Centro di Riferimento Oncologico (CRO), National Cancer Institute, Aviano, Italy.
authors: Sara
authors: S
authors: Piccinin
authors: Clinical and Experimental Onco-Hematology Unit, Centro di Riferimento Oncologico (CRO), National Cancer Institute, Aviano, Italy.
authors: Riccardo
authors: R
authors: Bomben
authors: Clinical and Experimental Onco-Hematology Unit, Centro di Riferimento Oncologico (CRO), National Cancer Institute, Aviano, Italy.
authors: Michele
authors: M
authors: Dal Bo
authors: Department of Radiation Oncology, Centro di Riferimento Oncologico (CRO), National Cancer Institute, Aviano, Italy.
authors: Marco
authors: M
authors: Trovo
authors: Clinical and Experimental Onco-Hematology Unit, Centro di Riferimento Oncologico (CRO), National Cancer Institute, Aviano, Italy.
authors: Valter
authors: V
authors: Gattei
authors: Division of Medical Oncology A, Centro di Riferimento Oncologico (CRO), National Cancer Institute, Aviano, Italy.
authors: Umberto
authors: U
authors: Tirelli
authors: Department of Radiation Oncology, Centro di Riferimento Oncologico (CRO), National Cancer Institute, Aviano, Italy.
authors: Giovanni
authors: G
authors: Franchin
authors: Clinical and Experimental Onco-Hematology Unit, Centro di Riferimento Oncologico (CRO), National Cancer Institute, Aviano, Italy.
authors: Pietro
authors: P
authors: Bulian
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D016403:Lymphoma, Large B-Cell, Diffuse / Q000473:pathology / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life / Q000523:psychology*
keywords: DLBCL; TP53; low-dose radiotherapy; palliation; quality of life