Radiotherapy for localized gastric mucosa–associated lymphoid tissue lymphoma: long-term outcomes over 10 years

Abstract

This study aimed to assess the long-term outcomes of radiotherapy in patients with localized gastric mucosa–associated lymphoid tissue (MALT) lymphoma. Twenty-seven patients with Stage I gastric MALT lymphoma were treated with radiotherapy from 1999 to 2010. The median age was 65 years (range: 31–84). Fifteen patients were Helicobacter pylori–negative. Thirteen patients were treated with definitive radiotherapy alone. The other 14 patients who had refractory or residual disease following a prior treatment received salvage radiotherapy. The median dose of the radiotherapy was 30 Gy in 20 fractions (range: 30–39.5 Gy). The median follow-up period was 121 months (range: 8–176 months). The 5- and 10-year overall survival rates for all patients were 92% and 87%, respectively. No patients died from MALT lymphoma. Three patients died of other diseases at 8, 33 and 74 months after radiotherapy (myocardial infarction, pneumonia and hepatocellular carcinoma, respectively). No cases of local recurrence were observed during the follow-up period. There were no serious late gastric, liver or kidney complications during a median follow-up period of over 10 years. Two patients remain alive with distant metastases: a lung metastasis and an abdominal lymph node metastasis at 104 months and 21 months after radiotherapy, respectively. Excellent long-term local control was observed in patients with localized gastric MALT lymphoma after radiotherapy. However, lifelong follow-up should be conducted to detect cases of late recurrence, especially distant metastases.

Long-Term Clinical Outcome and Predictive Factors for Relapse after Radiation Therapy in 145 Patients with Stage I Gastric B-Cell Lymphoma of Mucosa-Associated Lymphoid Tissue Type

“…There were no differences in treatment outcomes with RT dose (≤30 Gy vs. >30 Gy). Similar to our study, series with long-term follow-up after RT for gastric MALT lymphoma have reported ≥90% local control rates with standard RT doses of 30–36 Gy [ 12 , 13 , 14 ]. Given the highly favorable outcomes in patients with gastric MALT lymphoma using an RT dose of 30 Gy, studies regarding dose de-escalation are being conducted.…”

Outcomes After Reduced-Dose Intensity Modulated Radiation Therapy for Gastric Mucosa-Associated Lymphoid Tissue (MALT) Lymphoma

“…Long-term series have reported local control rates in excess of 90% after RT for gMALT with standard RT doses of 30-36 Gy (6,(8)(9)(10)(11). Given the highly favorable outcomes of patients with gMALT coupled with excellent results after 30 Gy, dose de-escalation may be considered.…”

Rituximab‐Bendamustine (R‐Benda) in MALT lymphoma complicating primary Sjögren syndrome (pSS)

“…The most important argument for treating pSS‐associated lymphomas is that chronic antigenic stimulation plays a key role in MALT lymphoma. Eradication of the infectious agent that drives this stimulation represents the cornerstone of the aetiological treatment in lymphomas complicating infection by hepatitis C virus or Helicobacter pylori (Ohkubo et al , ). In contrast to these 2 situations, the nature of the antigen is still unknown in pSS and currently cannot be eradicated.…”