PURPOSE: To investigate the potential for long-term survival for patients who relapsed after primary radiation therapy (RT) for early-stage low-grade follicular lymphoma and to assess the relative importance of prognostic factors. METHODS AND MATERIALS: Records were reviewed for 79 patients with stage I (n = 32) and II (n = 47) follicular small cleaved cell (fsc, n = 48) and follicular mixed small cleaved cell and large-cell (fmx, n = 31) lymphoma who relapsed after radical RT at Stanford University. Most patients had received doses of 35 to 45 Gy to involved (n = 30) or extended fields (n = 39) or total/subtotal lymphoid irradiation (n = 9). RESULTS: Median time to relapse was 2 years. Most relapses were detected on history (30%) or physical examination (66%). Positive relapse investigations included lymphangiogram (n = 19), chest radiograph (n = 5), and bone marrow biopsy (n = 6). Known extent of relapsed disease was: stage I, n = 30; stage II, n = 26; stage III, n = 10; and stage IV, n = 8. Patients were managed with "watchful waiting" (37%), further RT (39%), chemotherapy [CT, (17%)], or RT + CT (5%). Actuarial survival rates after relapse at 5, 10, 15, and 20 years were 56%, 35%, 17%, and 17% respectively. Median survival was 5.3 years after relapse. Median survival for relapse stage I, II, III, and IV was 10.2, 5.5, 3.0, and 1.1 years respectively. Progression-free survival rates at 5, 10, 15, and 20 years after relapse were 44%, 22%, 22%, and 22% respectively. Factors associated with reduced survival were increasing age, increasing relapse stage, symptoms, histologic transformation and > or = 3 relapse sites. Survival was the same for initial management with "watchful waiting" or RT. CONCLUSION: Approximately 20% of patients experienced prolonged survival after relapse. Younger, asymptomatic patients with stage I-II relapsed disease had the best outcome but results were inferior to those for newly diagnosed stage I-II disease.
PURPOSE: To investigate the potential for long-term survival for patients who relapsed after primary radiation therapy (RT) for early-stage low-grade follicular lymphoma and to assess the relative importance of prognostic factors. METHODS AND MATERIALS: Records were reviewed for 79 patients with stage I (n = 32) and II (n = 47) follicular small cleaved cell (fsc, n = 48) and follicular mixed small cleaved cell and large-cell (fmx, n = 31) lymphoma who relapsed after radical RT at Stanford University. Most patients had received doses of 35 to 45 Gy to involved (n = 30) or extended fields (n = 39) or total/subtotal lymphoid irradiation (n = 9). RESULTS: Median time to relapse was 2 years. Most relapses were detected on history (30%) or physical examination (66%). Positive relapse investigations included lymphangiogram (n = 19), chest radiograph (n = 5), and bone marrow biopsy (n = 6). Known extent of relapsed disease was: stage I, n = 30; stage II, n = 26; stage III, n = 10; and stage IV, n = 8. Patients were managed with "watchful waiting" (37%), further RT (39%), chemotherapy [CT, (17%)], or RT + CT (5%). Actuarial survival rates after relapse at 5, 10, 15, and 20 years were 56%, 35%, 17%, and 17% respectively. Median survival was 5.3 years after relapse. Median survival for relapse stage I, II, III, and IV was 10.2, 5.5, 3.0, and 1.1 years respectively. Progression-free survival rates at 5, 10, 15, and 20 years after relapse were 44%, 22%, 22%, and 22% respectively. Factors associated with reduced survival were increasing age, increasing relapse stage, symptoms, histologic transformation and > or = 3 relapse sites. Survival was the same for initial management with "watchful waiting" or RT. CONCLUSION: Approximately 20% of patients experienced prolonged survival after relapse. Younger, asymptomatic patients with stage I-II relapsed disease had the best outcome but results were inferior to those for newly diagnosed stage I-II disease.
Authors: Sweet Ping Ng; Richard Khor; Mathias Bressel; Michael MacManus; John F Seymour; Rodney J Hicks; Andrew Wirth Journal: Eur J Nucl Med Mol Imaging Date: 2018-08-07 Impact factor: 9.236
Authors: Michael S Binkley; Jessica L Brady; Carla Hajj; Monica Chelius; Karen Chau; Alex Balogh; Mario Levis; Andrea Riccardo Filippi; Michael Jones; Sameera Ahmed; Michael MacManus; Andrew Wirth; Masahiko Oguchi; Anders Krog Vistisen; Therese Youssef Andraos; Andrea K Ng; Berthe M P Aleman; Seo Hee Choi; Youlia M Kirova; Sara Hardy; Gabriele Reinartz; Hans T Eich; Scott V Bratman; Louis S Constine; Chang-Ok Suh; Bouthaina Dabaja; Tarec C El-Galaly; David C Hodgson; Umberto Ricardi; Joachim Yahalom; N George Mikhaeel; Richard T Hoppe Journal: Int J Radiat Oncol Biol Phys Date: 2019-03-08 Impact factor: 7.038