Strahlentherapie und Onkologie

, Volume 185, Issue 5, pp 288–295

Long-Term Outcome and Prognostic Factors in Early-Stage Nodal Low-Grade Non-Hodgkin’s Lymphomas Treated with Radiation Therapy

  • Hans Theodor Eich
  • Martina Heimann
  • Hartmut Stützer
  • Jan Kriz
  • Marcel Reiser
  • Rolf-Peter Müller
Original Article

Purpose:

Retrospective analysis of therapy results in patients with stage I–II and limited stage III nodal low-grade non-Hodgkin’s lymphoma (NHL).

Patients and Methods:

The present retrospective study covers 65 patients treated between 1988 and 2006 at the Department of Radiation Oncology, University of Cologne, Germany. 50 patients were treated with radiotherapy alone (EF [extended field]: n = 35, IF/REG [involved field/regional field]: n = 9, TNI/TLI [total nodal/total lymphatic]: n = 6), 15 patients additionally received chemotherapy. Median age was 58 years. 58 patients presented with centroblastic-centrocytic or follicular lymphomas, seven patients had centrocytic lymphomas. Apart from overall and relapse-free survival, relapse patterns were examined and the impacts of patient characteristics and therapy modalities were analyzed.

Results:

After a median follow-up of 9.1 years, overall 5-year and 10-year survival was 86% and 55%, relapse-free survival was 55% and 37%, respectively. Relapses occurred in 28 patients during the observation period. Overall survival was favorably influenced by low patient age (p = 0.037), centroblastic-centrocytic/follicular histology (p = 0.006), and early disease stage (p = 0.045). Favorable prognostic factors for relapse-free survival were low patient age (p = 0.035) and centroblastic-centrocytic/follicular histology (p = 0.001).

Conclusion:

Radiotherapy of early-stage low-grade NHL is a curative therapy option, particularly in younger patients and patients with follicular histology. Relapse analysis confirmed the benefits of total nodal or total lymphatic irradiation, although the small number of patients needs to be considered.

Key Words:

Non-Hodgkin’s lymphoma Low-grade Radiotherapy 

Behandlungsergebnisse und prognostische Faktoren nach Radiotherapie niedrigmaligner nodaler Non-Hodgkin-Lymphome in frühen Stadien

Ziel:

Retrospektive Auswertung der Behandlungsergebnisse bei Patienten mit niedrigmalignen nodalen Non-Hodgkin-Lymphomen (NHL) im Stadium I–II und im limitierten Stadium III.

Patienten und Methodik:

Die vorliegende retrospektive Studie umfasst 65 Patienten, die zwischen 1988 und 2006 in der Klinik und Poliklinik für Strahlentherapie der Universitäat zu Köln behandelt wurden. 50 Patienten erhielten eine alleinige Radiotherapie (EF [„extended field“]: n = 35, IF/REG [„involved field“]: n = 9, TNI/TLI [„total nodal/total lymphatic“]: n = 6), 15 Patienten zusätzlich eine Chemotherapie. Das mediane Alter betrug 58 Jahre. Bei 58 Patienten handelte es sich um ein zentroblastisch-zentrozytisches bzw. follikuläres Lymphom, bei sieben Patienten um ein zentrozytisches Lymphom. Neben Gesamtüberleben und rezidivfreiem Überleben wurden das Rezidivmuster untersucht und der prognostische Einfluss von Patientencharakteristika und Therapiemodalitäten analysiert.

Ergebnisse:

Bei einer medianen Nachbeobachtungszeit von 9,1 Jahren betrug das 5- bzw. 10-Jahres-Gesamtüberleben aller Patienten 86% und 55%, das rezidivfreie Überleben 55% und 37%. Bei 28 Patienten kam es im Verlauf zum Auftreten eines Rezidivs. Prognostisch günstigen Einfluss auf das Gesamtüberleben hatten niedriges Patientenalter (p = 0,037), zentroblastisch-zentrozytische/follikuläre Histologie (p = 0,006) und frühes Erkrankungsstadium (p = 0,045). Fur das rezidivfreie Überleben zeigten sich ebenfalls das jungere Alter (p = 0,035) und die zentroblastisch-zentrozytische/follikuläre Histologie (p = 0,001) als günstige Prognosefaktoren.

Schlussfolgerung:

Die Radiotherapie niedrigmaligner NHL in frühen Stadien ist eine kurative Therapieoption, insbesondere bei jungeren Patienten und follikulärer Histologie. In der Rezidivanalyse erwies sich die totale nodale bzw. totale lymphatische Bestrahlung als vorteilhaft, zu berücksichtigen ist jedoch die geringe Patientenzahl.

Schlüsselwörter:

Non-Hodgkin-Lymphome Niedrigmaligne Strahlentherapie 

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Copyright information

© Urban & Vogel, Muenchen 2009

Authors and Affiliations

  • Hans Theodor Eich
    • 1
    • 4
  • Martina Heimann
    • 1
  • Hartmut Stützer
    • 2
  • Jan Kriz
    • 1
  • Marcel Reiser
    • 3
  • Rolf-Peter Müller
    • 1
  1. 1.Department of Radiation OncologyUniversity of CologneKölnGermany
  2. 2.Institute of Medical Statistics, Informatics, and EpidemiologyUniversity of CologneKölnGermany
  3. 3.Clinic I for Internal MedicineUniversity of CologneKölnGermany
  4. 4.Department of Radiation OncologyUniversity of CologneKölnGermany

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