Radiation therapy is an effective modality in the treatment of mantle cell lymphoma, even in heavily pretreated patients

Clin Lymphoma Myeloma Leuk. 2014 Dec;14(6):474-9. doi: 10.1016/j.clml.2014.07.003. Epub 2014 Jul 15.

Abstract

Introduction: Mantle cell lymphoma has an aggressive clinical course and continuous relapse pattern with a median survival of 3 to 7 years. Multiple courses of chemotherapy are the basis of treatment. Radiotherapy is underutilized in this disease. We undertook this study to assess the role of radiation therapy.

Materials and methods: A total of 41 consecutive patients with mantle cell lymphoma diagnosed from December, 1999 to January, 2010 who received radiation therapy were reviewed retrospectively. The main endpoint was in-field lymphoma response at each irradiated disease site.

Results: There were 39 evaluable patients (68 symptomatic sites). Sites treated included: nodal stations (n = 31), soft tissue (n = 13), mucosal sites (n = 11), central nervous system (n = 10), gastrointestinal tract (n = 2), and bone (n = 1). Median maximum tumor size at presentation was 3.5 cm (range, 1.3 cm-9.6 cm). The median dose of radiation was 30.6 Gy (range 18-40 Gy). Median follow-up post radiation per site was 12.3 months (range, 0.6-80.9 months). Response to treatment was complete in 47 sites (69.1%), partial in 16 sites (23.5%), and 5 sites (7.4%) had stable disease. In 9 (13.2%) sites local relapse occurred (median 7 months; range 2-21). The mean size of lymphoma at time of RT correlated with relapse, with tumors with local relapse larger than those without a local relapse (P = .005).

Conclusions: Our data add to accumulating evidence that mantle cell lymphoma is a radio-sensitive disease with excellent responses to relatively low radiation doses, even in patients with chemo-refractory disease.

Keywords: Chemotherapy; In-field response; Refractory disease; Relapse; Site-specific treatment.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Combined Modality Therapy
  • Disease Progression
  • Female
  • Follow-Up Studies
  • Humans
  • Lymphoma, Mantle-Cell / mortality
  • Lymphoma, Mantle-Cell / pathology
  • Lymphoma, Mantle-Cell / radiotherapy*
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local
  • Neoplasm Staging
  • Radiotherapy Dosage
  • Retreatment
  • Treatment Outcome