Low-dose involved-field radiation in the treatment of non-hodgkin lymphoma: predictors of response and treatment failure
| Autor: | Peter Mauch, Arnold S. Freedman, Yu-Hui Chen, Anant Vinjamoori, E. Michaelson, Andrea K. Ng, Barbara Silver, Sarah K. Luthy, Andrea L. Russo, Neil E. Martin |
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| Rok vydání: | 2012 |
| Předmět: |
Adult
Male Cancer Research medicine.medical_specialty Disease Response Chronic lymphocytic leukemia medicine.medical_treatment Lymphoma Mantle-Cell Gastroenterology hemic and lymphatic diseases Internal medicine Medicine Humans Radiology Nuclear Medicine and imaging Treatment Failure Lymphoma Follicular Physical Examination Aged Proportional Hazards Models Aged 80 and over Radiation Radiotherapy business.industry Proportional hazards model Lymphoma Non-Hodgkin Hazard ratio Age Factors Radiotherapy Dosage Odds ratio Middle Aged medicine.disease Leukemia Lymphocytic Chronic B-Cell Surgery Lymphoma Tumor Burden Radiation therapy Radiography Oncology Mantle cell lymphoma Female business |
| Zdroj: | International journal of radiation oncology, biology, physics. 86(1) |
| ISSN: | 1879-355X |
| Popis: | Purpose: To investigate clinical and pathologic factors significant in predicting local response and time to further treatment after low-dose involved-field radiation therapy (LD-IFRT) for non-Hodgkin lymphoma (NHL). Methods and Materials: Records of NHL patients treated at a single institution between April 2004 and September 2011 were retrospectively reviewed. Low-dose involved-field radiation therapy was given as 4 Gy in 2 fractions over 2 consecutive days. Treatment response and disease control were determined by radiographic studies and/or physical examination. A generalized estimating equation model was used to assess the effect of tumor and patient characteristics on disease response. A Cox proportional hazards regression model was used to assess time to further treatment. Results: We treated a total of 187 sites in 127 patients with LD-IFRT. Histologies included 66% follicular, 9% chronic lymphocytic leukemia (CLL)/small lymphocytic lymphoma, 10% marginal zone, 6% mantle cell lymphoma (MCL), and 8% other. Median follow-up time was 23.4 months (range, 0.03-92.2 months). The complete response, partial response, and overall response rates were 57%, 25%, and 82%, respectively. A CLL histology was associated with a lower response rate (odds ratio 0.2, 95% confidence interval 0.1-0.5, P=.02). Tumor size, site, age at diagnosis, and prior systemic therapy were not associatedmore » with response. The median time to first recurrence was 13.6 months. Those with CLL and age ≤50 years at diagnosis had a shorter time to further treatment for local failures (hazard ratio [HR] 3.63, P=.01 and HR 5.50, P=.02, respectively). Those with CLL and MCL had a shorter time to further treatment for distant failures (HR 11.1 and 16.3, respectively, P |
| Databáze: | OpenAIRE |
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