Reduced dose radiotherapy for local control in non-Hodgkin lymphoma: A randomised phase III trial
Reduced dose radiotherapy for local control in non-Hodgkin lymphoma: A randomised phase III trial
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DOI：
10.1016/j.radonc.2011.05.013
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发表时间：
2011-07-01
影响因子：
5.7
通讯作者：
Hoskin, Peter
中科院分区：
文献类型：
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作者：
Lowry, Lisa;Smith, Paul;Hoskin, Peter
用途：这个多中心的，前瞻性的，随机对照试验比较了疗效和不同的放射治疗剂量的非霍奇金淋巴瘤（NHL）的毒性。患者和方法：患者与任何组织学亚型的NHL，需要放射治疗的局部疾病控制，无论是根治性，巩固性或姑息性，包括在内。361例惰性NHL（主要为滤泡性NHL和边缘区淋巴瘤）随机接受40 - 45戈伊分20 - 23次或24戈伊分12次治疗。640例侵袭性NHL（主要为弥漫性大B细胞淋巴瘤，作为联合治疗的一部分）患者随机接受40 - 45戈伊分20 - 23次治疗或30戈伊分15次治疗。所有阶段的疾病，一线和后续治疗的患者包括;第一次介绍的早期疾病predominated.Results：标准和低剂量武器之间的总反应率（ORR）没有差异。在惰性组中，ORR分别为93%和92%（p = 0.72）;在侵袭性组中，两组的ORR均为91%（p = 0.87）。中位随访时间为5.6年，在放射野内进展率方面没有检测到显著差异（惰性组HR = 1.09，95%CI = 0.76 - 1.56，p = 0.64;侵袭性组HR = 0.98，95%CI = 0.68 - 1.4，p = 0.89）。在无进展生存期或总生存期方面也没有检测到显著差异。有一个趋势，减少毒性低剂量武器，只有减少报告红斑达到significant.Conclusion：在一个大的，随机试验，有没有损失的疗效与放疗剂量为24戈伊在惰性NHL和30戈伊在侵略性NHL，与以前的标准剂量为4045戈伊。(c)2011爱思唯尔爱尔兰有限公司保留所有权利。放射治疗与肿瘤学100（2011）86 - 92
Purpose: This multicentre, prospective, randomised-controlled trial compared efficacy and toxicity of differing radiotherapy doses in non-Hodgkin lymphoma (NHL).Patients and methods: Patients with any histological subtype of NHL, requiring radiotherapy for local disease control, whether radical, consolidative or palliative, were included. Three hundred and sixty one sites of indolent NHL (predominantly follicular NHL and marginal zone lymphoma) were randomised to receive 40-45 Gy in 20-23 fractions or 24 Gy in 12 fractions. Six hundred and forty sites of aggressive NHL (predominantly diffuse large B cell lymphoma as part of combined-modality therapy) were randomised to receive 40-45 Gy in 20-23 fractions or 30 Gy in 15 fractions. Patients with all stages of disease, having first-line and subsequent therapies were included; first presentations of early-stage disease predominated.Results: There was no difference in overall response rate (ORR) between standard and lower-dose arms. In the indolent group, ORR was 93% and 92%, respectively, (p = 0.72); in the aggressive group, ORR was 91% in both arms (p = 0.87). With a median follow-up of 5.6 years, there was no significant difference detected in the rate of within-radiation field progression (HR = 1.09, 95%Cl = 0.76-1.56, p = 0.64 in the indolent group; HR = 0.98, 95%Cl = 0.68-1.4, p = 0.89 in the aggressive group). There was also no significant difference detected in the progression free or overall survival. There was a trend for reduced toxicities in the low-dose arms; only the reduction in reported erythema reached significance.Conclusion: In a large, randomised trial, there was no loss of efficacy associated with radiotherapy doses of 24 Gy in indolent NHL and 30 Gy in aggressive NHL, compared with previous standard doses of 4045 Gy. (c) 2011 Elsevier Ireland Ltd. All rights reserved. Radiotherapy and Oncology 100 (2011) 86-92