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- Title
Clinical outcomes with use of radiation therapy and risk of transformation in early-stage follicular lymphoma.
- Authors
Sha, Fushen; Okwali, Michelle; Alperovich, Anna; Caron, Philip C.; Falchi, Lorenzo; Hamilton, Audrey; Hamlin, Paul A.; Horwitz, Steven M.; Joffe, Erel; Khan, Niloufer; Kumar, Anita; Matasar, Matthew J.; Moskowitz, Alison J.; Noy, Ariela; Owens, Colette; Palomba, Lia M.; Rodriguez-Rivera, Ildefonso; Straus, David; von Keudell, Gottfried; Zelenetz, Andrew D.
- Abstract
Between 1998 and 2009, a total of 295 patients (median age 58, 53% females) with newly diagnosed early-stage follicular lymphoma (FL) were managed at Memorial Sloan Kettering Cancer Center. Approximately half of patients (137, 46%) underwent initial observation and half (158, 54%) immediate treatment: radiation alone (n = 108), systemic treatment alone (n = 29), or combined modality treatment (n = 21). Median follow-up was 8.4 years (range 0.3–17.2), and 10-year overall survival (OS) was 87.2%. OS was similar between initially-observed and immediately-treated patients (hazard ratio [HR]: 1.25, 95% CI: 0.67–2.36, p = 0.49). For patients receiving radiation alone, 5-year OS was 98.0%. Patients selected for systemic therapy alone had high-risk baseline features and had shorter OS than patients treated with radiation alone (HR 3.38, 95% CI 1.29–8.86, p = 0.01). Combined modality treatment did not yield superior survival compared with radiation alone (P > 0.05) but was associated with better progression-free survival (HR 0.36, 95% CI 0.14–0.90, p = 0.03). The rate of transformation increased steadily over time and was 4.2% at 5 years and 10.8% at 10 years. This modern-era analysis rationalized the role of initial observation in patients with early-stage FL although patients receiving radiation therapy also demonstrate excellent outcome.
- Subjects
MEMORIAL Sloan-Kettering Cancer Center; FOLLICULAR lymphoma; COMBINED modality therapy; RADIOTHERAPY; TREATMENT effectiveness; PROGRESSION-free survival
- Publication
Blood Cancer Journal, 2022, Vol 12, Issue 2, p1
- ISSN
2044-5385
- Publication type
Article
- DOI
10.1038/s41408-022-00620-w