Effectiveness and tolerability of radiotherapy for patients with indolent non-Hodgkin’s lymphoma: a monocenter analysis

Abstract To analyze the effectiveness and toxicities of radiotherapy in indolent non-Hodgkin’s lymphoma (iNHL) patients treated in our institution. Patients with iNHL treated with radiotherapy between 1999 and 2016 were included. The primary endpoint was progression-free survival (PFS). Secondary en...

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Autores principales:	I. Hadi, A. Schummer, M. Dreyling, C. Eze, R. Bodensohn, O. Roengvoraphoj, C. Belka, M. Li
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/d1140cde7c0a45d1aa60f5917fca5154
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spelling	oai:doaj.org-article:d1140cde7c0a45d1aa60f5917fca51542021-11-21T12:17:30ZEffectiveness and tolerability of radiotherapy for patients with indolent non-Hodgkin’s lymphoma: a monocenter analysis10.1038/s41598-021-01851-w2045-2322https://doaj.org/article/d1140cde7c0a45d1aa60f5917fca51542021-11-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-01851-whttps://doaj.org/toc/2045-2322Abstract To analyze the effectiveness and toxicities of radiotherapy in indolent non-Hodgkin’s lymphoma (iNHL) patients treated in our institution. Patients with iNHL treated with radiotherapy between 1999 and 2016 were included. The primary endpoint was progression-free survival (PFS). Secondary endpoints were local control (LC), overall survival (OS) and toxicities. PFS, LC, and OS were analyzed using Kaplan–Meier method. Log-rank test was used to investigate the differences between subgroups. Cox proportional hazard model was used for univariate continuous analysis. Seventy-five patients were identified in our institutional database between 1999 and 2016. Fifty-eight (77.3%) had stage I after Ann-Arbor and 17 patients (22.7%) had stage II. The median follow-up was 87 months (95% CI 72–102 months). Median single dose per fraction was 2.0 Gy (range 1.5–2 Gy) and median total dose was 30.6 Gy (range 16–45 Gy). Radiotherapy was performed in 2D (n = 10; 13.3%), 3D (n = 63; 84.0%) and VMAT (n = 2; 2.7%) techniques, respectively. The median PFS was 14.0 years (95% CI 8.3–19.7 years). The estimated PFS after 5 and 10 years were 73.0% and 65.5% in Kaplan–Meier analysis, respectively. The 5- and 10-year LC were 94.9% and 92.3%, respectively. The 5- and 10-year OS were 88.6% and 73.9%. In univariate analyses of PFS, younger patients (≤ 60 years old) had significantly superior PFS to those older than 60 years old (5-year PFS 81.9% vs. 65.1%, p = 0.021). Dose escalation > 36.0 Gy had no prognostic influence in term of PFS (p = 0.425). Extranodal involvement, stage and histology had no prognostic impact on PFS. Depending on the site of lymphomas, the most common acute side effects were: dermatitis CTCAE° I–II (8.0%), xerostomia CTC° I (8.0%), cataract CTC° I (12.0%) and dry eyes CTC° I–II (14.6%). No adverse event CTC° III was reported. Most acute side effects recovered at 3 to 6 months after radiotherapy except for CTC° I cataract and xerostomia. Local Radiotherapy was highly effective for treatment of early stage iNHL with no serious side effects in our cohort. The most acute CTCAE° I–II side effects recovered 3 to 6 months later. Technique advances seem to have further improved effectiveness and tolerability of radiotherapy. Trial registration: Local ethics committee of Ludwig-Maximilian-University (LMU) Munich approved this retrospective analysis on the May 7th, 2019 (Nr. 19–137).I. HadiA. SchummerM. DreylingC. EzeR. BodensohnO. RoengvoraphojC. BelkaM. LiNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-10 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q I. Hadi A. Schummer M. Dreyling C. Eze R. Bodensohn O. Roengvoraphoj C. Belka M. Li Effectiveness and tolerability of radiotherapy for patients with indolent non-Hodgkin’s lymphoma: a monocenter analysis
description	Abstract To analyze the effectiveness and toxicities of radiotherapy in indolent non-Hodgkin’s lymphoma (iNHL) patients treated in our institution. Patients with iNHL treated with radiotherapy between 1999 and 2016 were included. The primary endpoint was progression-free survival (PFS). Secondary endpoints were local control (LC), overall survival (OS) and toxicities. PFS, LC, and OS were analyzed using Kaplan–Meier method. Log-rank test was used to investigate the differences between subgroups. Cox proportional hazard model was used for univariate continuous analysis. Seventy-five patients were identified in our institutional database between 1999 and 2016. Fifty-eight (77.3%) had stage I after Ann-Arbor and 17 patients (22.7%) had stage II. The median follow-up was 87 months (95% CI 72–102 months). Median single dose per fraction was 2.0 Gy (range 1.5–2 Gy) and median total dose was 30.6 Gy (range 16–45 Gy). Radiotherapy was performed in 2D (n = 10; 13.3%), 3D (n = 63; 84.0%) and VMAT (n = 2; 2.7%) techniques, respectively. The median PFS was 14.0 years (95% CI 8.3–19.7 years). The estimated PFS after 5 and 10 years were 73.0% and 65.5% in Kaplan–Meier analysis, respectively. The 5- and 10-year LC were 94.9% and 92.3%, respectively. The 5- and 10-year OS were 88.6% and 73.9%. In univariate analyses of PFS, younger patients (≤ 60 years old) had significantly superior PFS to those older than 60 years old (5-year PFS 81.9% vs. 65.1%, p = 0.021). Dose escalation > 36.0 Gy had no prognostic influence in term of PFS (p = 0.425). Extranodal involvement, stage and histology had no prognostic impact on PFS. Depending on the site of lymphomas, the most common acute side effects were: dermatitis CTCAE° I–II (8.0%), xerostomia CTC° I (8.0%), cataract CTC° I (12.0%) and dry eyes CTC° I–II (14.6%). No adverse event CTC° III was reported. Most acute side effects recovered at 3 to 6 months after radiotherapy except for CTC° I cataract and xerostomia. Local Radiotherapy was highly effective for treatment of early stage iNHL with no serious side effects in our cohort. The most acute CTCAE° I–II side effects recovered 3 to 6 months later. Technique advances seem to have further improved effectiveness and tolerability of radiotherapy. Trial registration: Local ethics committee of Ludwig-Maximilian-University (LMU) Munich approved this retrospective analysis on the May 7th, 2019 (Nr. 19–137).
format	article
author	I. Hadi A. Schummer M. Dreyling C. Eze R. Bodensohn O. Roengvoraphoj C. Belka M. Li
author_facet	I. Hadi A. Schummer M. Dreyling C. Eze R. Bodensohn O. Roengvoraphoj C. Belka M. Li
author_sort	I. Hadi
title	Effectiveness and tolerability of radiotherapy for patients with indolent non-Hodgkin’s lymphoma: a monocenter analysis
title_short	Effectiveness and tolerability of radiotherapy for patients with indolent non-Hodgkin’s lymphoma: a monocenter analysis
title_full	Effectiveness and tolerability of radiotherapy for patients with indolent non-Hodgkin’s lymphoma: a monocenter analysis
title_fullStr	Effectiveness and tolerability of radiotherapy for patients with indolent non-Hodgkin’s lymphoma: a monocenter analysis
title_full_unstemmed	Effectiveness and tolerability of radiotherapy for patients with indolent non-Hodgkin’s lymphoma: a monocenter analysis
title_sort	effectiveness and tolerability of radiotherapy for patients with indolent non-hodgkin’s lymphoma: a monocenter analysis
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/d1140cde7c0a45d1aa60f5917fca5154
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Effectiveness and tolerability of radiotherapy for patients with indolent non-Hodgkin’s lymphoma: a monocenter analysis

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