Exclusive moderate-dose radiotherapy in gastric marginal zone B-cell MALT lymphoma: Results of a prospective study with a long term follow-up
Exclusive moderate-dose radiotherapy in gastric marginal zone B-cell MALT lymphoma: Results of a prospective study with a long term follow-up
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DOI：
10.1016/j.radonc.2015.08.029
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发表时间：
2015-10-01
影响因子：
5.7
通讯作者：
Quero, Laurent
中科院分区：
文献类型：
--
作者：
Ruskone-Fourmestraux, Agnes;Matysiak-Budnik, Tamara;Quero, Laurent
背景：在胃MALT淋巴瘤中，幽门螺杆菌（H。pylori）根除，中等剂量放疗（RT）的治疗已被提出，但其疗效尚未得到证实，在大型前瞻性系列与长期内镜follows.Method：局部胃MALT淋巴瘤患者持续后H。pylori根除患者接受中等剂量RT（30戈伊，2戈伊/次），随后每年进行内镜检查。结果：从1995年到2011年，在232例前瞻性随访的患者中，53例因H.幽门螺杆菌根除：分别在平均随访12个月和31个月后，肉眼可见溃疡（n = 31）或显微镜下淋巴瘤浸润（n = 22）。所有淋巴瘤均为局部淋巴瘤（45例IE期和8例HE期），38例（72%）为H。幽门阳性从诊断开始的平均临床和内镜随访时间为7.6年（2.2-19.1）。未发生急性或晚期毒性。在完成RT后中位随访4.9年（1.3-16.6）后，除1例（98%）患者外，所有患者均达到完全缓解，无复发。总生存率和5年疾病特异性生存率分别为94%和100%。结论：中剂量放疗（30戈伊）对H后胃MALT淋巴瘤持续存在的患者是安全有效的。根除幽门(C)2015爱思唯尔爱尔兰有限公司版权所有。
Background: In gastric MALT lymphomas persisting after Helicobacter pylori (H. pylori) eradication, a treatment by moderate-dose radiotherapy (RT) has been proposed but its efficacy has not been confirmed in large prospective series with long term endoscopic follow-up.Method: Patients with localised gastric MALT lymphoma persisting after H. pylori eradication were offered moderate-dose RT (30 Gy, 2 Gy/fraction) and followed with annual endoscopies. All biopsies before and after RT were reviewed by a committee of pathologists.Results: From 1995 to 2011, out of the 232 patients followed prospectively, 53 received RT for persistence of lymphoma after H. pylori eradication: either macroscopic ulcer (n = 31), or microscopic lymphomatous infiltrate (n = 22), after a mean follow-up of 12 and 31 months, respectively. All lymphomas were localised (45 stage IE and 8 stage HE) and 38 (72%) were H. pylori-positive. The mean clinical and endoscopic follow-up from diagnosis was 7.6 years (2.2-19.1). No acute or late toxicity occurred. A complete remission was achieved in all patients but one (98%) with no relapse after a median follow-up of 4.9 years (1.3-16.6) after completion of RT. Overall survival and 5-year disease specific survival were 94% and 100%, respectively. One patient died of gastric adenocarcinoma.Conclusion: Moderate-dose RT (30 Gy) is effective and safe for localised gastric MALT lymphoma persisting after H. pylori eradication. (C) 2015 Elsevier Ireland Ltd. All rights reserved.