Low-dose fractionated whole-body irradiation in the treatment of advanced non-Hodgkin's lymphoma. [Effectiveness and complications]
Thirty-nine patients with advanced non-Hodgkin's lymphoma (38 patients with lymphocytic lymphoma and 1 patient with mixed lymphocytic and histiocytic lymphoma) were treated by fractionated low dose whole body irradiation (WBI) with a minimum follow-up of 8 months. Twenty-eight patients had no previous treatment and the other 11 patients were in relapse after previous chemotherapy or regional radiotherapy. There were 20 and 19 patients in stages III and IV groups, respectively. The majority of patients (31) had nodular histology; diffuse lymphocytic lymphoma was present in 8 patients (Rappaport criteria) (9). Constitutional symptoms were present in 10 patients. Thirty-three (85%) attained complete remission (CR) with median duration of remission 24 months. Actuarial survival was 78% and 74% at 3 and 4 years. However, relapse free survival was 26% at 3 and 4 years. A prospective randomized trial to compare 10 vs. 15 rad per fraction of fractionated WBI schedules (the same total dose 150 rad) demonstrated no difference in response rate, response duration, and median nadir platelet or WBC counts between the two schedules. Supplement radiotherapy to bulky tumor site prevented local recurrence, but did not influence survival or duration or remission. Major toxicity was thrombocytopenia with median nadir platelet counts 77,000/mm/sup 3/ (11,000 to 170,000/mm/sup 3/). Five of 6 patients with diffuse lymphocytic poorly differentiated lymphoma attained CR. However, their median survival was 30 months which is much shorter than that of nodular lymphoma. Constitutional symptoms and advanced stage (stage IV) were associated with shorter duration of remission. Response of patients in relapse after WBI to subsequent chemotherapy +- local radiotherapy was CR in 50% and PR in 40%. Fractionated whole body irradiation is an excellent systemic induction agent for advanced lymphocytic and mixed lymphoma.
- Research Organization:
- Harvard Medical School, Boston, MA
- OSTI ID:
- 6000357
- Journal Information:
- Cancer; (United States), Journal Name: Cancer; (United States) Vol. 43:5; ISSN CANCA
- Country of Publication:
- United States
- Language:
- English
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560151* -- Radiation Effects on Animals-- Man
62 RADIOLOGY AND NUCLEAR MEDICINE
63 RADIATION, THERMAL, AND OTHER ENVIRON. POLLUTANT EFFECTS ON LIVING ORGS. AND BIOL. MAT.
ACCELERATORS
ANIMAL CELLS
ANOREXIA
BETA DECAY RADIOISOTOPES
BETA-MINUS DECAY RADIOISOTOPES
BIOLOGICAL EFFECTS
BIOLOGICAL MATERIALS
BIOLOGICAL RADIATION EFFECTS
BLOOD
BLOOD CELLS
BLOOD COUNT
BLOOD PLATELETS
BODY FLUIDS
BONE MARROW CELLS
COBALT 60
COBALT ISOTOPES
CONNECTIVE TISSUE CELLS
DATA
DATA FORMS
DISEASES
ELECTROMAGNETIC RADIATION
ELECTROSTATIC ACCELERATORS
EXPERIMENTAL DATA
EXTERNAL IRRADIATION
FRACTIONATED IRRADIATION
GAMMA RADIATION
HEMIC DISEASES
HEMORRHAGE
INFORMATION
INTERMEDIATE MASS NUCLEI
INTERNAL CONVERSION RADIOISOTOPES
IONIZING RADIATIONS
IRRADIATION
ISOLATED VALUES
ISOMERIC TRANSITION ISOTOPES
ISOTOPES
LEUKOCYTES
LEUKOPENIA
LOW DOSE IRRADIATION
LYMPHOMAS
MEDICINE
MINUTES LIVING RADIOISOTOPES
NEOPLASMS
NUCLEAR MEDICINE
NUCLEI
NUMERICAL DATA
ODD-ODD NUCLEI
PATHOLOGICAL CHANGES
PATIENTS
RADIATION EFFECTS
RADIATIONS
RADIOINDUCTION
RADIOISOTOPES
RADIOLOGY
RADIOTHERAPY
SIDE EFFECTS
SOMATIC CELLS
SYMPTOMS
THERAPY
VAN DE GRAAFF ACCELERATORS
WHOLE-BODY IRRADIATION
YEARS LIVING RADIOISOTOPES