Treatment Results According to Cellular Subtypes of Gastric Malt Lymphoma

Abstract

modes of fractionation (92.6% -CF, 85.7% -MF (p > 0.1), and dose delivery methods (2D -95.8%; 3D -83.3%, p = 0.06), a strong tendency to reduce radiation reactions using 3D-CRT. Analyzing SE of different fractionation modes and different ways of planning, we found that the MF and 3D-CRT SE were in 2 of 21 (9.5%) patients, while CF and 3D-CRT -18 of 27 (66.7%) patients (p < 0.01); at MF and 2D-RT -16 of 21 (76.2%) patients, while CF and 2D-RT -7 out of 27 (25.9%) (p < 0.05). Thus, the smallest number of SE observed in the group of MF 3D-CRT; at CF and 2D-RT SE were significantly increased than with 3D-CRT and MF (p < 0.05); the number of SE at CF (3D) and MF (2D) did not differ. Total dose is evaluated on intact eyes in 28 patients with involvement of the orbit. With 3D-CRT (14 patients) the average of total dose on the intact eye was 2.0 ± 0.2 Gy; at 2D-RT (14 patients) -5.7 ± 1.2 Gy, p < 0.05. Conclusion:The modern approaches in radiation therapy of patients with OL (MF, 3D-CRT) at preservation of high antitumor effect promote decrease of quantity of early reactions, and 3D-CRT also to the considerable (by 2 and 5 times) to decrease in total dose on an intact eye. Methods: One hundred and twelve patients with MALT lymphoma were studied including 41 patients with gastrointestinal (GI) involvement and 71 patients with non-GI involvement: 35 ocular adnexa; 9 lung; 8 parotid; 5 thyroid; 3 subcutaneous tissue; 2 thachea; 2 tonsil; 2 submandibular gland; 2 thymus; 1 bladder; 1 oral cavity and 1 breast.The 22.3% patients had advanced Ann Arbor stage. Comparisons between GI and non-GI patients showed a larger percentage of B symptoms and lymph nodes involvement in GI MALT lymphoma patients.Results: A total of 101 patients (90.2%) made response to the first-line treatment, and there was no significant difference between the two groups. With a median follow-up duration of 31 months, estimated of progression-free survival (PFS) and overall survival (OS) at 5 years was 85.5% and 92.9%, respectively. Neither PFS nor OS showed significant difference between the two groups. Multivariate analysis showed that lymph nodes involvement, International Prognostic Index (IPI) and absolute monocyte counts (AMC) were independent significant prognostic factors for PFS (Fig. 1). Conclusion:MALT lymphoma is an indolent lymphoma with a longterm survival. The presence of lymph nodes involvement, IPI ≥3 and high AMC at diagnosis were significantly associated with inferior PFS.Keywords: extranodal marginal zone lymphoma of MALT type; prognostic indices.