Radiation Therapy for Relapsed or Refractory Diffuse Large B-Cell Lymphoma: What Is the Right Regimen for Palliation?

Wright, Christopher M.; Dreyfuss, Alexandra D.; Baron, Jonathan; Maxwell, Russell; Mendes, Amberly; Barsky, Andrew R.; Doucette, Abigail; Svoboda, Jakub; Chong, Elise A.; Jones, Joshua; Maity, Amit; Plastaras, John P.; Paydar, Ima

doi:10.1016/j.adro.2022.101016

Cited by 5 publications

(2 citation statements)

References 33 publications

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“…The ORR was 60% for the entire cohort. No statistically significant differences were observed in ORR, time to local failure (TTLF), and OS between hypofractionation and conventional fractionation [33]. Takahashi et al retrospectively reviewed the outcomes of 162 patients with aggressive NHL treated with radical, consolidative, or palliative RT.…”

Section: Discussionmentioning

confidence: 99%

Hypofractionated Radiotherapy for Hematologic Malignancies during the COVID-19 Pandemic and Beyond

Antony,

Dubey,

Skrabek

et al. 2024

Current Oncology

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Purpose: Radiotherapy is integral in the management of hematological malignancies (HM). Standard radiotherapy dose fractionation regimens range between 20 and 50 Gy in 10–25 fractions over 2–5 weeks. This study presents the outcomes of patients with HM treated with hypofractionation radiotherapy (HFRT) during the COVID-19 pandemic. Methods: Patients (n = 36) were treated with HFRT between January 2020 and September 2022. The outcomes measured were the overall response rate (ORR), freedom from local progression (FFLP), and overall survival (OS). Results: The median follow-up was 13.2 months. Thirty-three patients (92%) had non-Hodgkin (NHL) or Hodgkin lymphoma (HL). Eighteen patients (50%) had aggressive and nine (25%) had indolent NHL. Nineteen patients (53%) presented with stage I/II and fifteen (42%) with stage III/IV disease. Twenty-five (69.4%) and eleven (30%) received consolidative and definitive RT, respectively. Twenty patients (56%) received treatment to the neck and/or thorax and nine (25%) to the abdomen or pelvis. The total dose ranged from 18 to 42.5 Gy in 6–17 fractions/2.67–5 Gy per fraction. The median dose in 2 Gy fractions for an alpha/beta (α/β) ratio of 10 amounted to 39 Gy (SD ± 13.86) and 43.6 Gy (SD ± 12) for an α/β of 3. The most commonly used fractionation scheme was 39 Gy in 13 fractions. ORR was 94.4% for the entire cohort, and 100, 94.4, and 83.3% for indolent NHL, aggressive NHL, and HL patients. The two-year FFLP was 76% (95% CI: 34–93%) for the entire cohort and 100, 87 (95% CI: 56.4–96.5%), and 42% (95% CI: 1.1–84.3%) for the indolent NHL, aggressive NHL, and HL patients. Two-year OS for the entire cohort was 80% (95% CI: 59.9–90.5%) and 100, 66.1 (95% CI: 36.4–84.4%), and 100% for the indolent NHL, aggressive NHL, and HL patients. Only one patient presented with grade two pulmonary toxicity. Conclusions: HFRT in HM provides excellent local control to be validated in a larger prospective study.

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Section: Discussionmentioning

confidence: 99%

Hypofractionated Radiotherapy for Hematologic Malignancies during the COVID-19 Pandemic and Beyond

Antony,

Dubey,

Skrabek

et al. 2024

Current Oncology

View full text Add to dashboard Cite

show abstract

“…ORR was 60% for the entire cohort. No statistically significant differences were observed in ORR, time to local failure (TTLF), and OS between hypofractionation and conventional fractionation [28]. Others retrospectively reviewed the outcome of 162 patients with aggressive NHL treated with radical, consolidative, or palliative RT.…”

Section: Discussionmentioning

confidence: 99%

Hypofractionated Radiotherapy for Hematologic Malignancies during the COVID-19 Pandemic and Beyond

Febin Antony,

Dubey,

Skrabek

et al. 2023

Preprint

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Purpose Radiotherapy is integral in the management of hematological malignancies (HM). Standard radiotherapy dose fractionation regimens range between 20-50 Gy in 10-25 fractions over 2-5 weeks. This study presents the outcomes of patients with HM treated with hypofractionation radiotherapy (HFRT) during the COVID-19 pandemic. Methods Patients (N=36) were treated with HFRT between January 2020 and September 2022. The outcomes measured were the overall response rate (ORR), freedom from local progression (FFLP), and overall survival (OS). Results Median follow-up was 13.2 months. Thirty-three patients (92%) had non-Hodgkin (NHL) or Hodgkin lymphoma (HL). Eighteen patients (50%) had aggressive and 9 (25%) had indolent NHL. Nineteen patients (53%) presented with stage I/II and 15(42%) with stage III/IV disease. Twenty-five (69.4%) and eleven (30%) received consolidative and definitive RT, respectively. Twenty patients (56%) received treatment to the neck and/or thorax, and 9 (25%) to the abdomen or pelvis. Total dose ranged from 18 to 42.5 Gy in 6-17 fractions/ 2.67-5 Gy per fraction. Median dose in 2 Gy fractions for an alpha/beta (α/β) ratio of 10 amounted to 39 Gy (SD ± 13.86), and 43.6 Gy (SD ± 12) for an α/β of 3. The most commonly used fractionation scheme was 39 Gy in 13 fractions. ORR was 94.4% for the entire cohort, and 100, 94.4, and 83.3% for indolent NHL, aggressive NHL, and HL patients. Two-year FFLP was 76% (95% CI: 34-93%) for the entire cohort, and 100, 87 (95%CI: 56.4-96.5%) and 42% (95% CI: 1.1-84.3%) for the indolent NHL, aggressive NHL, and HL patients. Two-year OS for the entire cohort was 80% (95% CI:59.9-90.5%), and 100, 66.1 (95% CI: 36.4-84.4%) and 100% for the indolent NHL, aggressive NHL, and HL patients. Only one patient presented with grade two pulmonary toxicity. Conclusion HFRT in HM provides excellent local control without any increase in toxicity.

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Radiotherapeutic palliation of lymphoma

Wright¹,

Koroulakis²,

Paydar³

et al. 2024

Palliative Radiation Oncology

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Radiation Therapy for Relapsed or Refractory Diffuse Large B-Cell Lymphoma: What Is the Right Regimen for Palliation?

Cited by 5 publications

References 33 publications

Hypofractionated Radiotherapy for Hematologic Malignancies during the COVID-19 Pandemic and Beyond

Hypofractionated Radiotherapy for Hematologic Malignancies during the COVID-19 Pandemic and Beyond

Hypofractionated Radiotherapy for Hematologic Malignancies during the COVID-19 Pandemic and Beyond

Radiotherapeutic palliation of lymphoma

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