Maximum disease diameter is associated with outcomes in stage II follicular lymphoma treated with radiation therapy alone
- Author(s)
- Xu, Y; Campbell, BA; Chan, M; Chan, J; Farinha, P; Venner, CP; Scott, DW; Gerrie, AS; Villa, D; Sehn, LH; Savage, KJ; Lo, AC;
- Journal Title
- Clinical and Translational Radiation Oncology
- Publication Type
- Research article
- Abstract
- PURPOSE: The optimal management of stage II follicular lymphoma (FL) is unclear. Radiation therapy (RT) alone has been the gold standard treatment, but a proportion of patients relapse. We sought to characterize outcomes and prognostic factors for stage II FL treated with RT alone to identify a high-risk subgroup of patients who may benefit from treatment intensification. METHODS: This was a population-based, province-wide, retrospective study. Included patients had grade 1-3A, non-mesenteric, stage IIA or IIAE FL diagnosed between 1986 and 2016 and treated with curative-intent (≥20 Gy) RT alone. RESULTS: 102 patients were included. Median follow-up was 10.4 years (range, 0.3-22.3). Median age was 59 years (range, 33-86). Median greatest disease diameter was 3.6 cm (range, 1.5-11.5). Freedom from progression (FFP) was 60.3% at 5 years and 40.7% at 10 years. Overall survival (OS) was 89.2% at 5 years and 81.8% at 10 years. Greatest disease diameter of >3.6 cm was associated with inferior FFP (10-year FFP 34% vs. 47%, p = 0.013) on univariable analysis and inferior FFP (hazard ratio [HR] 1.87, p = 0.019) and inferior OS (HR 2.12, p = 0.027) on multivariable analysis (MVA). Older age was associated with inferior OS (HR 1.08, unit = 1 year, p < 0.001) on MVA. CONCLUSIONS: 40.7% of stage II FL patients treated with RT alone remained disease-free at 10 years. Greatest disease diameter >3.6 cm was associated with inferior FFP and OS, representing a novel prognostic indicator in this population that may help in the decision-making process on whether to complement RT with systemic therapy.
- Publisher
- Elsevier
- Keywords
- Kaplan-Meier Estimate; Lymphoma, Follicular; Prognosis; Radiotherapy; Survival Analysis; Treatment Outcome
- Department(s)
- Radiation Oncology
- Publisher's Version
- https://doi.org/10.1016/j.ctro.2024.100869
- Terms of Use/Rights Notice
- Refer to copyright notice on published article.
Creation Date: 2024-11-12 06:11:14
Last Modified: 2024-11-12 06:12:19