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Strahlentherapie und Onkologie

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01-02-2020 | Lymphoma | Original Article

De-escalated radiotherapy for indolent primary cutaneous B-cell lymphoma

Authors: Michael Oertel, MD, Khaled Elsayad, Carsten Weishaupt, Kerstin Steinbrink, Hans Theodor Eich

Published in: Strahlentherapie und Onkologie | Issue 2/2020

Abstract

Objective

Radiotherapy (RT) has an established role in the curative treatment of indolent primary cutaneous B‑cell lymphoma (PCBCL). With the role of low-dose regimens such as 2 × 2 Gy being uncertain, we compared conventional-dose RT to a low-dose approach and investigated outcome and toxicities.

Materials and methods

We retrospectively reviewed the medical records of 26 patients with 44 cutaneous lesions treated at our institution between 2007 and 2017, comprising 22 marginal zone lymphoma (PCMZL) lesions and 22 follicle center lymphoma (PCFCL) lesions. Seven lesions (16%) were treated with low-dose RT (LDRT) (4 Gy) and 37 (84%) with conventional-dose RT (≥24 Gy, median 40 Gy). Median follow-up duration was 76 months.

Results

The overall response rate (ORR) was 91% (complete response rate [CRR]: 75%). The 5‑year local control rate (LCR) was 88% and the 10-year LCR was 84%. The response rates were significantly higher following conventional-dose RT (ORR: 92% vs. 86%; CRR: 84% vs. 29%; P = 0.007). In terms of radiation dose, the rate of infield relapses (14% vs. 11%, P = 0.4) and the 5‑year LCR (86% vs. 90%, P = 0.4) were comparable in the LDRT and conventional-dose RT groups. During RT courses, about two-thirds of patients experienced mild toxicities, with grade I and II acute toxicity rates of 61% and 9%, respectively, with lower incidences of grade I (14% vs. 70%) and grade II (0% vs. 8%, P = 0.004) toxicities following LDRT.

Conclusion

This long-term analysis confirms the excellent outcome of RT in the management of PCBCL. The LDRT concept with 4 Gy was associated with a comparable LCR and reduced rates of acute toxicity. However, the response rates were significantly lower for this group and LDRT may therefore not be recommended as standard treatment.

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Title: De-escalated radiotherapy for indolent primary cutaneous B-cell lymphoma
Authors: Michael Oertel, MD
Khaled Elsayad
Carsten Weishaupt
Kerstin Steinbrink
Hans Theodor Eich
Publication date: 01-02-2020
Publisher: Springer Berlin Heidelberg
Keywords: Lymphoma
Malignant Skin Lymphomas
Radiotherapy
Published in: Strahlentherapie und Onkologie / Issue 2/2020
Print ISSN: 0179-7158
Electronic ISSN: 1439-099X
DOI: https://doi.org/10.1007/s00066-019-01541-7

Keynote webinar | Spotlight on medication adherence

Springer Medicine

De-escalated radiotherapy for indolent primary cutaneous B-cell lymphoma

Abstract

Objective

Materials and methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objective

Materials and methods

Results

Conclusion

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