Value of radiation therapy in the management of chemoresistant intermediate grade non-Hodgkin's lymphoma
Autor: | Amr Aref, Maria Dan, Mary Varterasian, Chatchada Karanes, Ayad Al-Katib, David Eilender, B S Samir Narayan, Samuel Tekyi-Mensah |
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Rok vydání: | 1999 |
Předmět: |
Adult
Male Oncology medicine.medical_specialty Adolescent Subsequent Relapse medicine.medical_treatment Disease-Free Survival Stable Disease Internal medicine Antineoplastic Combined Chemotherapy Protocols medicine Humans Radiology Nuclear Medicine and imaging Cumulative incidence Intermediate Grade Aged Retrospective Studies Chemotherapy Radiation Dose-Response Relationship Drug Radiological and Ultrasound Technology business.industry Lymphoma Non-Hodgkin Middle Aged medicine.disease Surgery Lymphoma Non-Hodgkin's lymphoma Survival Rate Radiation therapy Drug Resistance Neoplasm Female Radiotherapy Adjuvant business Follow-Up Studies |
Zdroj: | Radiation Oncology Investigations. 7:186-191 |
ISSN: | 1520-6823 1065-7541 |
DOI: | 10.1002/(sici)1520-6823(1999)7:3<186::aid-roi8>3.0.co;2-2 |
Popis: | The purpose of this study was to evaluate the probability and extent of response to radiation therapy in patients with chemotherapy-resistant intermediate grade non-Hodgkin's lymphoma. Thirty-five patients with chemotherapy-resistant non-Hodgkin's lymphoma received local radiation therapy after initial treatment with at least six cycles of systemic chemotherapy. There were 17 men and 18 women in our study. Ages ranged from 15 to 68 years, median age was 42 years. Chemotherapy resistance was defined as relapse after initial chemotherapy (11 patients) or failure to achieve complete remission (partial response in 18 patients, stable disease in 1 patient, and disease progression in 5 patients). Radiation doses were between 1,980–5,040 cGy (median dose of 3,200 cGy). Treatment outcome was evaluated with respect to any subsequent relapse either within or outside the irradiated region. The 2-year actuarial survival was 65%. The cumulative incidence of isolated local failure and any local failure at 2 years were 33% and 54%, respectively. Tumors that responded to initial chemotherapy had a better local control probability than tumors that did not respond. The 2-year actuarial local failure rates for these two groups were 51% and 83%, respectively (P = 0.01). There was a trend for improved local control with radiation doses ≥3,960 cGy, suggesting the presence of a dose–control relationship. The rate of disease progression within an irradiated region in patients with intermediate grade non-Hodgkin's lymphoma that relapsed after or failed to respond completely to full course chemotherapy was substantially higher than the historical in-field failure rates when radiation therapy was used as the sole modality of treatment. Prior response to initial chemotherapy was a predicting factor for local control following radiation therapy. Radiat. Oncol. Invest. 7:186–191, 1999. © 1999 Wiley-Liss, Inc. |
Databáze: | OpenAIRE |
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