Radiat Oncol J.  2016 Sep;34(3):193-201. 10.3857/roj.2016.01865.

Radiation therapy for gastric mucosa-associated lymphoid tissue lymphoma: dose-volumetric analysis and its clinical implications

• Lim HW
• Kim TH
• Choi IJ
• Kim CG
• Lee JY
• Cho SJ
• Eom HS
• Moon SH
• Kim DY

• KMID: 2356115
• DOI: http://doi.org/10.3857/roj.2016.01865

Abstract

PURPOSE
To assess the clinical outcomes of radiotherapy (RT) using two-dimensional (2D) and three-dimensional conformal RT (3D-CRT) for patients with gastric mucosa-associated lymphoid tissue (MALT) lymphoma to evaluate the effectiveness of involved field RT with moderate-dose and to evaluate the benefit of 3D-CRT comparing with 2D-RT.
MATERIALS AND METHODS
Between July 2003 and March 2015, 33 patients with stage IE and IIE gastric MALT lymphoma received RT were analyzed. Of 33 patients, 17 patients (51.5%) were Helicobacter pylori (HP) negative and 16 patients (48.5%) were HP positive but refractory to HP eradication (HPE). The 2D-RT (n = 14) and 3D-CRT (n = 19) were performed and total dose was 30.6 Gy/17 fractions. Of 11 patients who RT planning data were available, dose-volumetric parameters between 2D-RT and 3D-CRT plans was compared.
RESULTS
All patients reached complete remission (CR) eventually and median time to CR was 3 months (range, 1 to 15 months). No local relapse occurred and one patient died with second primary malignancy. Tumor response, survival, and toxicity were not significantly different between 2D-RT and 3D-CRT (p > 0.05, each). In analysis for dose-volumetric parameters, D(max) and CI for PTV were significantly lower in 3D-CRT plans than 2D-RT plans (p < 0.05, each) and D(mean) and V₁₅ for right kidney and D(mean) for left kidney were significantly lower in 3D-CRT than 2D-RT (p < 0.05, each).
CONCLUSION
Our data suggested that involved field RT with moderate-dose for gastric MALT lymphoma could be promising and 3D-CRT could be considered to improve the target coverage and reduce radiation dose to the both kidneys.

Keyword

Lymphoma; Stomach; Radiotherapy

MeSH Terms

Helicobacter pylori
Humans
Kidney
Lymphoid Tissue
Lymphoma
Lymphoma, B-Cell, Marginal Zone*
Radiotherapy
Recurrence
Stomach