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Medline ® Abstract for Reference 42

of 'Management of gastrointestinal lymphomas'

Exclusive moderate-dose radiotherapy in gastric marginal zone B-cell MALT lymphoma: Results of a prospective study with a long term follow-up.
Ruskoné-Fourmestraux A, Matysiak-Budnik T, Fabiani B, Cervera P, Brixi H, Le Malicot K, Nion-Larmurier I, Fléjou JF, Hennequin C, Quéro L, Groupe d’Étude des Lymphomes Digestifs (GELD)&Fédération Francophone de Cancérologie Digestive
Radiother Oncol. 2015;117(1):178.
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.
METHOD: 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.
CONCLUSION: Moderate-dose RT (30Gy) is effective and safe for localised gastric MALT lymphoma persisting after H. pylori eradication.
Department of Gastroenterology, St Antoine Hospital, AP-HP, Facultéde Médicine Pierre et Marie Curie, Paris, France; Fédération Francophone de Cancérologie Digestive (FFCD), Dijon, France. Electronic address: agnes.fourmestraux@sat.aphp.fr.