Low-dose radiotherapy in diffuse large B-cell lymphoma

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Abstract

Low-dose radiotherapy (LDRT) given in 2 × 2 Gy is a highly effective and safe treatment for palliation of indolent lymphomas. Otherwise, very little regarding the use of LDRT for diffuse large B-cell lymphoma (DLBCL) has been investigated. We designed a phase 2 trial of LDRT in patients with DLBCL with indication for palliative radiation. Low-dose radiotherapy was administered on symptomatic areas only. Clinical response was assessed 21 days after LDRT and defined as reduction >50% of maximum diameter of the radiated lesions. Quality of life was scored by the European Organisation for Research and Treatment of Cancer QLQ-C30 questionnaire. Tumor subtype (germinal center B-cell type versus activated B-cell type) and the presence of TP53 mutations in pathologic specimens of the target lesion were also evaluated. Twenty-three of twenty-five radiated patients were evaluable for response, and 2 died of disease before the visit at 21 days. The overall response rate was 70% (16 of 23 patients), with 7 complete responses and 9 partial responses (mean duration of response, 6 months; range, 1-39 months). Fifteen patients answered to the QLQ-C30 questionnaires, and an improved quality of life was documented in 9 cases. TP53 mutations were detected in 2 of 6 (33%) nonresponders and in none of the responders (P =.12). Germinal center B-cell type responded better than activated B-cell type (response rate was 83% and 29%, respectively, P =.01). These findings indicate that LDRT is effective for palliation in patients with DLBCL. Copyright © 2016 John Wiley & Sons, Ltd.
Original languageEnglish
Pages (from-to)472-479
Number of pages8
JournalHematological Oncology
Volume35
Issue number4
DOIs
Publication statusPublished - 2017

Keywords

  • DLBCL
  • low-dose radiotherapy
  • palliation
  • quality of life
  • TP53
  • biological marker
  • protein p53
  • adult
  • aged
  • Article
  • cancer palliative therapy
  • cancer patient
  • cancer radiotherapy
  • clinical article
  • Clinical Target Volume
  • diffuse large B cell lymphoma
  • female
  • follow up
  • gene mutation
  • germinal center
  • human
  • low dose radiotherapy
  • male
  • phase 2 clinical trial
  • physical examination
  • priority journal
  • radiation dose
  • treatment response
  • clinical trial
  • disease free survival
  • middle aged
  • pathology
  • prospective study
  • psychology
  • very elderly
  • Adult
  • Aged
  • Aged, 80 and over
  • Disease-Free Survival
  • Female
  • Humans
  • Lymphoma, Large B-Cell, Diffuse
  • Male
  • Middle Aged
  • Prospective Studies
  • Quality of Life

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