Radiotherapy for indolent primary cutaneous B-cell lymphoma: an international multicenter ILROG analysis
Abstract
Abstract Radiotherapy is an established treatment for low-grade primary cutaneous B-cell lymphoma. Recommendations on its use differ internationally, which prompted our group to conduct this analysis. Twenty-two institutions participated in this international study. Patient eligibility required a diagnosis of limited (T1/T2) primary cutaneous marginal zone or follicle center lymphoma treated with radiotherapy between 1995 and 2023. Data were collected retrospectively until February 2024 within the framework of the International Lymphoma Radiation Oncology Group. Overall, 535 patients were analyzed. Predominant locations were the head (40%) and trunk (36%). Radiotherapy had a median dose of 24 Gy in fractions of 2 Gy. Complete responses were observed in 91% at a median time of 3.6 months following radiotherapy. There was no statistically significant difference between treatments ≤4 Gy and >4 Gy for complete or overall response rates (P = .077 and P = .056, respectively). However, there was an inferior duration of local control with ≤4 Gy (5-year local control 73% ± 12% vs 96% ± 2%; P< .001). Radiation dose was the main prognostic factor in the univariate and multivariable Cox analysis; however, higher doses did not translate into an overall survival benefit. Toxicities rarely exceeded grade 2 but were more frequent in the >4 Gy group. Radiotherapy remains an effective treatment option for indolent skin lymphoma with low toxicity. High response rates are observed with low doses of ≤4 Gy. In comparison to conventional doses, these treatments have a shorter duration of local control but a favorable toxicity profile.
Article Details
Authors (37)
Michael Oertel
Bouthaina Dabaja
Dennis Görlich
Bjorn R. Thomas
5St John’s Institute of Dermatology, Guy’s and St Thomas’ National Health Service Trust, London, United Kingdom
Van Sim
5St John’s Institute of Dermatology, Guy’s and St Thomas’ National Health Service Trust, London, United Kingdom
Philippa Johnstone
6Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
Ayesha Hashmi
8Department of Radiation Oncology, Stanford University School of Medicine, Palo Alto, CA
Mario Levis
9Department of Oncology, University of Turin, Turin, Italy
Bradley Ackerson
10Department of Radiation Oncology, Duke University Medical Center, Durham, NC
Christina Hague
11Department of Clinical Oncology, The Christie National Health Service Foundation Trust, Manchester, United Kingdom
Christopher R. Weil
3Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
John Plastaras
13Department of Radiation Oncology, Perelman Center for Advanced Medicine, University of Pennsylvania, Philadelphia, PA
Daniel Roos
14Department of Radiation Oncology, Royal Adelaide Hospital, Adelaide University School of Medicine, Adelaide, SA, Australia
Youlia Kirova
15Department of Radiation Oncology, Institut Curie, Paris, France
Rainer Fietkau
Penny Q. Fang
3Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
Andrea Ng
18Department of Radiation Oncology, Brigham and Women’s Hospital, Boston, MA
Felix Bock
19Department of Radiotherapy and Radiation Oncology, University Medical Center Rostock, Rostock, Germany
Yolanda D. Tseng
20Department of Radiation Oncology, University of Washington, and Division of Radiation Oncology, Fred Hutchinson Cancer Center, Seattle, WA
Philipp Linde
21Department of Radiation Oncology, Cyberknife and Radiation Therapy, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany
Jürgen Dunst
22Department of Radiation Oncology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
Stephanie Terezakis
23Department of Radiation Oncology, University of Minnesota Medical School, Minneapolis, MN
Teresa Easwaran
23Department of Radiation Oncology, University of Minnesota Medical School, Minneapolis, MN
Jan C. Peeken
Andrea Wittig
27Department of Radiotherapy and Radiation Oncology, University Hospital Jena, Friedrich Schiller University Jena, Jena, Germany
Hong In Yoon
29Department of Radiation Oncology, Yonsei University College of Medicine, Seoul, Korea
Randa Tao
12Department of Radiation Oncology, University of Utah School of Medicine, Salt Lake City, UT
Timothy Illidge
30Manchester Academic Health Science Centre, Manchester Cancer Research Centre, University of Manchester, Cancer Research United Kingdom, The Christie National Health Service Foundation Trust, Manchester, United Kingdom
Chris R. Kelsey
10Department of Radiation Oncology, Duke University Medical Center, Durham, NC
Umberto Ricardi
Michael S. Binkley
Belinda A. Campbell
6Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
Stephen Morris
Khaled Elsayad
1Department of Radiation Oncology, University Hospital Münster, Münster, Germany
Michael Storck
34Institute of Medical Informatics, University of Münster, Münster, Germany
Richard T. Hoppe
Hans Theodor Eich
1Department of Radiation Oncology, University Hospital Münster, Münster, Germany