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Medline ® Abstract for Reference 41

of 'Management of gastrointestinal lymphomas'

Long-term outcome for gastric marginal zone lymphoma treated with radiotherapy: a retrospective, multi-centre, International Extranodal Lymphoma Study Group study.
Wirth A, Gospodarowicz M, Aleman BM, Bressel M, Ng A, Chao M, Hoppe RT, Thieblemont C, Tsang R, Moser L, Specht L, Szpytma T, Lennard A, Seymour JF, Zucca E
Ann Oncol. 2013 May;24(5):1344-51. Epub 2013 Jan 4.
Background We evaluated the long-term results of radiotherapy for patients with gastric marginal zone lymphoma (GMZL). Patients and methods We carried out a retrospective, multi-centre study of patients with low-grade GMZL treated by radiotherapy between 17 July 1981 and 25 March 2004. Results There were 102 eligible patients. Fifty-eight patients were previously untreated and 44 had recurrent/residual disease after prior treatment (HP eradication, chemotherapy and surgery in 35, 9 and 8 patients, respectively, and 7 had>1 prior therapy). Radiation fields included the stomach /involved nodes in 61 patients and whole abdomen in 41. The median radiotherapy dose to stomach was 40 Gy (range 26-46 Gy) in a median 22 fractions. With a median follow-up after radiotherapy of 7.9 years (range 0.3-24 years), 10- and 15-year freedom from treatment failure (FFTF) was 88% (95% CI 82%-95%). Risk factors for TF were a large-cell component (P = 0.036) and an exophytic growth pattern (P = 0.042). Radiotherapy field size, radiotherapy dose, and failure of prior therapy were not associated with inferior FFTF. Ten-year overall survival was 70% (95% CI 60%-82%). Conclusions Radiotherapy achieves cure for the majority of patients with low-grade GMZL, including patients who have had prior therapy. Several features may predict a poorer outcome.
Division Radiation Oncology and Cancer Imaging, Peter MacCallum Cancer Centre, East Melbourne and University of Melbourne, Parkville, Victoria, Australia.