Outcome after radiation therapy for Langerhans cell histiocytosis is dependent on site of involvement Journal Article

Authors: Laird, J.; Ma, J.; Chau, K.; Chelius, M.; Shi, W.; Zhang, Z.; Lok, B. H.; Yahalom, J.
Article Title: Outcome after radiation therapy for Langerhans cell histiocytosis is dependent on site of involvement
Abstract: Purpose: To characterize the efficacy and safety of radiation therapy in a contemporary Langerhans cell histiocytosis (LCH) cohort and to explore whether there are sites at higher risk for local recurrence. Patients and Methods: Between 1995 and 2015 we identified 39 consecutive LCH patients who were treated primarily with radiation therapy. Patients were staged by single/multisystem involvement and established risk organ criteria. In 46 irradiated lesions, clinical and radiologic responses were evaluated at multiple time points after radiation therapy. Patient demographics, treatment, and local failure were compared by site of lesion. Results: Median age at radiation therapy was 35 years (range, 1.5-67 years). Twelve patients had multisystem involvement, and of those, 5 patients had disease in organs considered to be high risk. The following sites were irradiated: bone (31), brain (6), skin (3), lymph node (3), thyroid (2), and nasopharynx (1). Median dose was 11.4 Gy (range, 7.5-50.4 Gy). At a median follow-up of 45 months (range, 6-199 months), local recurrence or progression was noted in 5 of 46 lesions (11%). There were no local failures of the 31 bone lesions evaluated, whereas the 3-year freedom from local failure in the 15 non-bone lesions was 63% (95% confidence interval 32-83%; P=.0008). Local failures occurred in 2 of 3 skin lesions, in 2 of 6 brain lesions, and 1 of 3 lymph node lesions. Deaths were recorded in 5 of 39 patients (13%), all of whom were adults with multisystem disease. Conclusion: Radiation therapy is a safe and effective measure for providing local control of LCH involving the bone. Whereas bone lesions are well controlled with low doses of radiation, disease in other tissues, such as the skin and brain, may require higher doses of radiation or additional treatment modalities. © 2017 Elsevier Inc.
Keywords: radiation; radiotherapy; confidence interval; bone; body fluids; local control; local recurrence; langerhans cells; brain lesions; radiologic response; additional treatment; effective measures
Journal Title: International Journal of Radiation Oncology, Biology, Physics
Volume: 100
Issue: 3
ISSN: 0360-3016
Publisher: Elsevier Inc.  
Date Published: 2018-03-01
Start Page: 670
End Page: 678
Language: English
DOI: 10.1016/j.ijrobp.2017.10.053
PROVIDER: scopus
PMCID: PMC5806138
PUBMED: 29413280
Notes: Article -- Export Date: 1 May 2018 -- Source: Scopus
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MSK Authors
  1. Zhigang Zhang
    238 Zhang
  2. Joachim Yahalom
    391 Yahalom
  3. Weiji Shi
    110 Shi
  4. Benjamin H Lok
    52 Lok
  5. Jennifer Ma
    30 Ma
  6. James   Laird
    12 Laird
  7. Karen Chau
    14 Chau