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Early stage W.H.O. grade I and II follicular lymphoma treated with radiation therapy alone.

Ahmed N, Owen TE, Rubinger M, Williams G, Nugent Z, Ahmed S, Cooke A - PLoS ONE (2013)

Bottom Line: Age ≥60 at diagnosis was associated with reduced OS, p = 0.029, but did not affect PFS.No other clinical features including grade or FLIPI were significant for outcomes.In this highly selected homogeneous group the FLIPI loses discriminating ability.

View Article: PubMed Central - PubMed

Affiliation: University of Manitoba, Winnipeg, Manitoba, Canada.

ABSTRACT

Objectives: This retrospective study was undertaken to evaluate the outcome of patients with stage I or II (limited stage), grade I-II follicular non-Hodgkin's lymphoma (FL) treated with radiation therapy (RT) alone as initial management.

Methods: Patients with stage I or II and pathologically confirmed WHO grade I or II FL treated initially with RT alone between 1982 and 2008 were identified from a population based cancer registry.

Results: Forty patients with a mean age 61.3 years at diagnosis were identified. The median follow up was 6.9 years from the end of radiation therapy. Stage was I (n = 26) and II (n = 14). None had B symptoms. The Follicular Lymphoma International Prognostic Index (FLIPI) was low risk in 26 patients and intermediate risk in 5. Doses ranged from 15 Gy to 48 Gy, with a median dose of 35 Gy. All patients achieved a complete clinical response (CR). 5 and 10 year overall survival (OS) was 86% and 59%, progression free survival (PFS) 67% and 54%. Age ≥60 at diagnosis was associated with reduced OS, p = 0.029, but did not affect PFS. No other clinical features including grade or FLIPI were significant for outcomes. Local failure was uncommon occurring in 8% (3/40) although this was 21% (3/14) of all recurrences.

Conclusions: OS and PFS outcomes for radiation alone in limited stage low grade FL patients from this single institution study are consistent with previously published data. No predictors were prognostic for PFS. A dose of ≤35 Gy may be appropriate. In this highly selected homogeneous group the FLIPI loses discriminating ability. Local control is excellent, and a majority of patients are free of disease after 5 years.

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Related in: MedlinePlus

Overall survival, progression free survival and event free survival for all patients.
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Related In: Results  -  Collection


getmorefigures.php?uid=PMC3675117&req=5

pone-0065156-g001: Overall survival, progression free survival and event free survival for all patients.

Mentions: Figure 1 shows PFS, OS and EFS for all patients. The median OS post-radiation was 13.0 years, median EFS was 6.5 years. Five and 10 year OS for all patients was 86% and 59%, respectively. The 5 and 10 year PFS were 67% and 54%. The 5 and 10 year EFS for all patients was 60% and 22%. Patients ≥60 years old were at a higher risk of dying, HR 4.31, (95% CI 1.17–15.9) p = 0.030 but this includes all causes. Age was not a prognostic factor for EFS, HR 1.52 (95% 0.65–3.57) p = 0.34.


Early stage W.H.O. grade I and II follicular lymphoma treated with radiation therapy alone.

Ahmed N, Owen TE, Rubinger M, Williams G, Nugent Z, Ahmed S, Cooke A - PLoS ONE (2013)

Overall survival, progression free survival and event free survival for all patients.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3675117&req=5

pone-0065156-g001: Overall survival, progression free survival and event free survival for all patients.
Mentions: Figure 1 shows PFS, OS and EFS for all patients. The median OS post-radiation was 13.0 years, median EFS was 6.5 years. Five and 10 year OS for all patients was 86% and 59%, respectively. The 5 and 10 year PFS were 67% and 54%. The 5 and 10 year EFS for all patients was 60% and 22%. Patients ≥60 years old were at a higher risk of dying, HR 4.31, (95% CI 1.17–15.9) p = 0.030 but this includes all causes. Age was not a prognostic factor for EFS, HR 1.52 (95% 0.65–3.57) p = 0.34.

Bottom Line: Age ≥60 at diagnosis was associated with reduced OS, p = 0.029, but did not affect PFS.No other clinical features including grade or FLIPI were significant for outcomes.In this highly selected homogeneous group the FLIPI loses discriminating ability.

View Article: PubMed Central - PubMed

Affiliation: University of Manitoba, Winnipeg, Manitoba, Canada.

ABSTRACT

Objectives: This retrospective study was undertaken to evaluate the outcome of patients with stage I or II (limited stage), grade I-II follicular non-Hodgkin's lymphoma (FL) treated with radiation therapy (RT) alone as initial management.

Methods: Patients with stage I or II and pathologically confirmed WHO grade I or II FL treated initially with RT alone between 1982 and 2008 were identified from a population based cancer registry.

Results: Forty patients with a mean age 61.3 years at diagnosis were identified. The median follow up was 6.9 years from the end of radiation therapy. Stage was I (n = 26) and II (n = 14). None had B symptoms. The Follicular Lymphoma International Prognostic Index (FLIPI) was low risk in 26 patients and intermediate risk in 5. Doses ranged from 15 Gy to 48 Gy, with a median dose of 35 Gy. All patients achieved a complete clinical response (CR). 5 and 10 year overall survival (OS) was 86% and 59%, progression free survival (PFS) 67% and 54%. Age ≥60 at diagnosis was associated with reduced OS, p = 0.029, but did not affect PFS. No other clinical features including grade or FLIPI were significant for outcomes. Local failure was uncommon occurring in 8% (3/40) although this was 21% (3/14) of all recurrences.

Conclusions: OS and PFS outcomes for radiation alone in limited stage low grade FL patients from this single institution study are consistent with previously published data. No predictors were prognostic for PFS. A dose of ≤35 Gy may be appropriate. In this highly selected homogeneous group the FLIPI loses discriminating ability. Local control is excellent, and a majority of patients are free of disease after 5 years.

Show MeSH
Related in: MedlinePlus