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Title: Whole-abdomen radiotherapy for non-Hodgkin's lymphoma using twice-daily fractionation

Abstract

Purpose: To report the tolerability and efficacy of twice-daily whole-abdomen irradiation (WAI) for non-Hodgkin's lymphoma (NHL). Methods and Materials: Of 123 patients treated for NHL with WAI, 37% received previous chemotherapy, 28% received WAI as part of comprehensive lymphatic irradiation (CLI), and 32% received WAI for palliation. The median dose to the whole abdomen was 25.0 Gy, followed by a median tumor boost of 9.8 Gy in 58 patients. Fractionation was 1.0 Gy once daily (54%) or 0.8 Gy twice daily (46%). Blood counts were measured weekly. Results: At a median follow-up of 4.3 years, local control was 72% and overall survival was 55% at 5 years. Median time of WAI was 42 days for once-daily treatment and 32 days for twice-daily treatment. Patients receiving twice-daily WAI did not have a significantly higher rate of acute side effects (e.g., nausea, diarrhea, platelet or red blood cell toxicity). Overall, acute thrombocytopenia was the most frequent side effect of treatment; 24 of 96 patients (25%) with available hematologic data had Grade 3+ toxicity. There was no acute Grade 3 gastrointestinal toxicity and no late small bowel obstruction. Multiple regression indicated that patients with four or less involved sites and disease size {<=}6more » cm had improved local control and overall survival. Conclusions: Twice-daily WAI using 0.8 Gy/fraction does not appear to have any greater toxicity compared with once-daily treatment using 1 Gy/fraction. Small doses per fraction (0.8-1 Gy/fx) are effective, tolerated well in the acute setting, and associated with a low rate of late toxicity.« less

Authors:
 [1];  [2];  [1];  [1];  [1]
  1. Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, FL (United States)
  2. Department of Radiation Oncology, Clarian Health Methodist-IU-Riley Hospital, Indianapolis, IN (United States)
Publication Date:
OSTI Identifier:
20850268
Resource Type:
Journal Article
Journal Name:
International Journal of Radiation Oncology, Biology and Physics
Additional Journal Information:
Journal Volume: 66; Journal Issue: 5; Other Information: DOI: 10.1016/j.ijrobp.2006.07.014; PII: S0360-3016(06)01255-7; Copyright (c) 2006 Elsevier Science B.V., Amsterdam, Netherlands, All rights reserved; Country of input: International Atomic Energy Agency (IAEA); Journal ID: ISSN 0360-3016
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; ABDOMEN; BLOOD CELLS; BLOOD COUNT; CHEMOTHERAPY; DIARRHEA; FRACTIONATED IRRADIATION; LYMPHOMAS; NAUSEA; PATIENTS; RADIATION DOSES; RADIOTHERAPY; SIDE EFFECTS; TOXICITY

Citation Formats

Liauw, Stanley L, Yeh, Alexander M, Morris, Christopher G, Olivier, Kenneth R, and Mendenhall, Nancy Price. Whole-abdomen radiotherapy for non-Hodgkin's lymphoma using twice-daily fractionation. United States: N. p., 2006. Web. doi:10.1016/j.ijrobp.2006.07.014.
Liauw, Stanley L, Yeh, Alexander M, Morris, Christopher G, Olivier, Kenneth R, & Mendenhall, Nancy Price. Whole-abdomen radiotherapy for non-Hodgkin's lymphoma using twice-daily fractionation. United States. https://doi.org/10.1016/j.ijrobp.2006.07.014
Liauw, Stanley L, Yeh, Alexander M, Morris, Christopher G, Olivier, Kenneth R, and Mendenhall, Nancy Price. 2006. "Whole-abdomen radiotherapy for non-Hodgkin's lymphoma using twice-daily fractionation". United States. https://doi.org/10.1016/j.ijrobp.2006.07.014.
@article{osti_20850268,
title = {Whole-abdomen radiotherapy for non-Hodgkin's lymphoma using twice-daily fractionation},
author = {Liauw, Stanley L and Yeh, Alexander M and Morris, Christopher G and Olivier, Kenneth R and Mendenhall, Nancy Price},
abstractNote = {Purpose: To report the tolerability and efficacy of twice-daily whole-abdomen irradiation (WAI) for non-Hodgkin's lymphoma (NHL). Methods and Materials: Of 123 patients treated for NHL with WAI, 37% received previous chemotherapy, 28% received WAI as part of comprehensive lymphatic irradiation (CLI), and 32% received WAI for palliation. The median dose to the whole abdomen was 25.0 Gy, followed by a median tumor boost of 9.8 Gy in 58 patients. Fractionation was 1.0 Gy once daily (54%) or 0.8 Gy twice daily (46%). Blood counts were measured weekly. Results: At a median follow-up of 4.3 years, local control was 72% and overall survival was 55% at 5 years. Median time of WAI was 42 days for once-daily treatment and 32 days for twice-daily treatment. Patients receiving twice-daily WAI did not have a significantly higher rate of acute side effects (e.g., nausea, diarrhea, platelet or red blood cell toxicity). Overall, acute thrombocytopenia was the most frequent side effect of treatment; 24 of 96 patients (25%) with available hematologic data had Grade 3+ toxicity. There was no acute Grade 3 gastrointestinal toxicity and no late small bowel obstruction. Multiple regression indicated that patients with four or less involved sites and disease size {<=}6 cm had improved local control and overall survival. Conclusions: Twice-daily WAI using 0.8 Gy/fraction does not appear to have any greater toxicity compared with once-daily treatment using 1 Gy/fraction. Small doses per fraction (0.8-1 Gy/fx) are effective, tolerated well in the acute setting, and associated with a low rate of late toxicity.},
doi = {10.1016/j.ijrobp.2006.07.014},
url = {https://www.osti.gov/biblio/20850268}, journal = {International Journal of Radiation Oncology, Biology and Physics},
issn = {0360-3016},
number = 5,
volume = 66,
place = {United States},
year = {Fri Dec 01 00:00:00 EST 2006},
month = {Fri Dec 01 00:00:00 EST 2006}
}