Radiation Therapy Outcome and Clinical Features of Duodenal-Type Follicular Lymphoma
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Purpose Duodenal-type follicular lymphoma (FL) is a rare variant of FL. There is still no consensus on the initial treatment, and clinical features including endoscopic findings are not familiar to most physicians. The objective of this study was to evaluate the outcome of patients who were initially treated with radiation therapy for duodenal-type FL. Materials and Methods We retrospectively analyzed 20 patients who were consecutively diagnosed with duodenaltype FL between 2008 and 2017. All patients received radiation therapy with curative intent. Results The median age of the patients was 52 years (range, 26 to 66 years), and females were predominant. Most patients (n=18, 90%) had stage I disease, and were diagnosed by a regular health examination in an asymptomatic state. The histological grade was one in 19 patients (95%), and the endoscopic findings were diffuse nodular (n=8), whitish granular (n=8), and mixed pattern (n=4). Radiation therapy was delivered to 17 patients with 24 Gy in 12 fractions, and to three patients with 30.6-36 Gy in 18 fractions. All patients were evaluated with endoscopy for response to radiation therapy, and complete response was achieved in 19 patients (95%). At the time of analysis, all patients survived without any evidence of late toxicities related with radiation therapy. Conclusion Taken together, radiation therapy alone could be effective in controlling duodenal lesion. A further study with longer follow-up duration is warranted to confirm our findings.
Abstract
Purpose Duodenal-type follicular lymphoma (FL) is a rare variant of FL. There is still no consensus on the initial treatment, and clinical features including endoscopic findings are not familiar to most physicians. The objective of this study was to evaluate the outcome of patients who were initially treated with radiation therapy for duodenal-type FL. Materials and Methods We retrospectively analyzed 20 patients who were consecutively diagnosed with duodenaltype FL between 2008 and 2017. All patients received radiation therapy with curative intent. Results The median age of the patients was 52 years (range, 26 to 66 years), and females were predominant. Most patients (n=18, 90%) had stage I disease, and were diagnosed by a regular health examination in an asymptomatic state. The histological grade was one in 19 patients (95%), and the endoscopic findings were diffuse nodular (n=8), whitish granular (n=8), and mixed pattern (n=4). Radiation therapy was delivered to 17 patients with 24 Gy in 12 fractions, and to three patients with 30.6-36 Gy in 18 fractions. All patients were evaluated with endoscopy for response to radiation therapy, and complete response was achieved in 19 patients (95%). At the time of analysis, all patients survived without any evidence of late toxicities related with radiation therapy. Conclusion Taken together, radiation therapy alone could be effective in controlling duodenal lesion. A further study with longer follow-up duration is warranted to confirm our findings.
참고문헌 (18)
- Takata K, "Primary gastrointestinal follicular lymphoma involving the duodenal second portion is a distinct entity : a multicenter, retrospective analysis in Japan", Cancer Sci, 102, pp.1532~1536 (2011)
- Kim SJ, "Multicenter retrospective analysis of 581 patients with primary intestinal non-hodgkin lymphoma from the Consortium for Improving Survival of Lymphoma(CISL)", BMC Cancer, 11, pp.321~ (2011)
- Swerdlow SH, "The 2016 revision of the World Health Organization classification of lymphoid neoplasms", Blood, 127, pp.2375~2390 (2016)
- Anderson JR, "Epidemiology of the non-Hodgkin's lymphomas: distributions of the major subtypes differ by geographic locations. Non-Hodgkin's Lymphoma Classification Project", Ann Oncol, 9, pp.717~720 (1998)
- Yamamoto S, "Gastrointestinal follicular lymphoma : review of the literature", J Gastroenterol, 45, pp.370~388 (2010)
- Yoshino T, "Increased incidence of follicular lymphoma in the duodenum", Am J Surg Pathol, 24, pp.688~693 (2000)
- Takata K, "Duodenal follicular lymphoma : comprehensive gene expression analysis with insights into pathogenesis", Cancer Sci, 105, pp.608~615 (2014)
- 맹치훈, "Treatment outcomes and clinical relevance of the Follicular Lymphoma International Prognostic Index in Korean follicular lymphoma patients treated with chemotherapy", The Korean Journal of Internal Medicine, 31(3), pp.560~569 (2016), 대한내과학회
- Ahmed N, "Early stage W.H.O. grade I and II follicular lymphoma treated with radiation therapy alone", PLoS One, 8, pp.e65156~ (2013)
- Harada A, "Radiation therapy for localized duodenal lowgrade follicular lymphoma", J Radiat Res, 57, pp.412~417 (2016)
- Solal-Celigny P, "Follicular lymphoma international prognostic index", Blood, 104, pp.1258~1265 (2004)
- Roulland S, "Follicular lymphoma-like B cells in healthy individuals : a novel intermediate step in early lymphomagenesis", J Exp Med, 203, pp.2425~2431 (2006)
- Schmatz AI, "Primary follicular lymphoma of the duodenum is a distinct mucosal", submucosal variant of follicular lymphoma : a retrospective study of 63 cases, 2011, pp.29, 1445~1451
- Bende RJ, "Primary follicular lymphoma of the small intestine : alpha4beta7 expression and immunoglobulin configuration suggest an origin from local antigen-experienced B cells", Am J Pathol, 162, pp.105~113 (2003)
- Leung WK, "Screening for gastric cancer in Asia : current evidence and practice", Lancet Oncol, 9, pp.279~287 (2008)
- Iwamuro M, "Primary intestinal follicular lymphoma : How to identify follicular lymphoma by routine endoscopy", World J Gastrointest Endosc, 5, pp.34~38 (2013)
- Lowry L, "Reduced dose radiotherapy for local control in non-Hodgkin lymphoma : a randomised phase III trial", Radiother Oncol, 100, pp.86~92 (2011)
- Yahalom J, "Modern radiation therapy for extranodal lymphomas : field and dose guidelines from the International Lymphoma Radiation Oncology Group", Int J Radiat Oncol Biol Phys, 92, pp.11~31 (2015)