Treatment of mucosa-associated lymphoid tissue lymphoma of the stomach with radiation alone Journal Article

Authors: Schechter, N. R.; Portlock, C. S.; Yahalom, J.
Article Title: Treatment of mucosa-associated lymphoid tissue lymphoma of the stomach with radiation alone
Abstract: Purpose: Mucosa-associated lymphoid tissue (MALT) lymphoma of the stomach (MLS) has recently been defined as a distinct clinicopathologic entity, often associated with Helicobacter pylori infection. Many regard antibiotic therapy as the primary treatment of MLS, but in the absence of H pylori infection, or when salvage of antibiotic failures is required, gastrectomy and/or chemotherapy have frequently been used. This study evaluates the efficacy of low-dose radiotherapy alone as an alternative to surgery. Patients and Methods: Seventeen patients with stage I to II2 low- grade MLS without evidence of H pylori infection or with persistent lymphoma after antibiotic therapy of associated H pylori infection were included in this series. Median age was 69 years (range, 39 to 84). Median total radiation dose was 30 Gy (range, 28.5 to 43.50 Gy) delivered in 1.5-Gy fractions within 4 weeks to the stomach and adjacent lymph nodes. Following treatment, all patients underwent endoscopic evaluation and biopsy at a median of 4 months, at 6-month intervals to 2 years, and annually thereafter. Results: All obtained a biopsy-confirmed complete response. At a median follow-up time of 27 months (range, 11 to 68) from completion of radiotherapy, event-free survival was 100%. Treatment was well tolerated, with no significant acute side effects. All remained asymptomatic at last follow-up. Conclusion: These results suggest that effective treatment of MLS with low-dose radiation therapy alone is feasible and safe, and allows stomach preservation. Longer follow-up evaluation is required to determine the long-term efficacy of this treatment approach and its side effects. Further studies should clarify the indications for radiotherapy in H pylori- negative or antibioticresistant cases of MLS.
Keywords: adult; clinical article; aged; aged, 80 and over; disease-free survival; middle aged; antibiotic therapy; cancer radiotherapy; follow up; follow-up studies; radiotherapy dosage; tetracycline; metronidazole; stomach neoplasms; gastroscopy; helicobacter pylori; stomach tumor; amoxicillin; mucosa associated lymphoid tissue lymphoma; gram negative infection; famotidine; stomach biopsy; lymphoma, mucosa-associated lymphoid tissue; bismuth salicylate; humans; human; male; female; priority journal; article
Journal Title: Journal of Clinical Oncology
Volume: 16
Issue: 5
ISSN: 0732-183X
Publisher: American Society of Clinical Oncology  
Date Published: 1998-05-01
Start Page: 1916
End Page: 1921
Language: English
PUBMED: 9586910
PROVIDER: scopus
DOI: 10.1200/JCO.1998.16.5.1916
Notes: Article -- Export Date: 12 December 2016 -- Source: Scopus
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MSK Authors
  1. Joachim Yahalom
    394 Yahalom
  2. Carol Portlock
    178 Portlock