Improved survival in patients with early stage low-grade follicular lymphoma treated with radiation: a Surveillance, Epidemiology, and End Results database analysis.

摘要: BACKGROUND: External beam radiation therapy (RT) is the standard treatment for stage I-II, grade 1-2 follicular lymphoma. Because of an indolent natural history, some advocate alternative management strategies, including watchful waiting this disease. The relative improvement in outcomes patients treated with and without RT has never been tested randomized trials. METHODS: The Surveillance, Epidemiology, End Results database was queried adult lymphoma diagnosed from 1973 to 2004. Retrievable patient data included age, sex, race, stage, extranodal disease, within first year after diagnosis. Actuarial overall survival (OS) disease-specific (DSS) were analyzed. RESULTS: A total 6568 identified. DSS at 5, 10, 15, 20 years group 90%, 79%, 68%, 63% versus 81%, 66%, 57%, 51% no (hazard ratio [HR], 0.61; 95% confidence interval [CI], 0.55-0.68; P < .0001). OS 62%, 45%, 35% 71%, 48%, 34%, 23% not receiving (HR, 0.68; CI, 0.63-0.73; On multivariate analysis, upfront remained independently associated improved (P .0001, Cox HR, 0.65; 0.57-0.72) .0001; 0.73; 0.67-0.79). Lymphoma most common cause death (52%). Only 34% received RT. CONCLUSIONS: Upfront compared alternate approaches, a benefit that persisted over time. This suggests administration salvage therapies on progression/relapse do compensate inadequate initial definitive treatment. Although it care early low-grade greatly underused US population; increased use could prevent thousands deaths these patients. Cancer 2010. © 2010 American Society.