Outcomes of radiation therapy of indolent cutaneous B-cell lymphomas and literature review.

Abstract

BACKGROUND:

Primary cutaneous B-cell lymphomas represent approximately 25% of primary cutaneous lymphomas. Follicular centre cell lymphomas (PCFCL) and marginal zone lymphomas (PCMZL) are the two histological subtypes that present an indolent evolution. Radiotherapy is one of the recommended treatment options with few series reported.

OBJECTIVE:

This study aimed to evaluate radiotherapy outcomes in term of overall survival (OS) and disease-free survival (DFS) for patients suffering from a PCMZL or PCFCL, to search for predictive factors of recurrence, and to evaluate chronic and aesthetics adverse events and patient's satisfaction.

METHODS:

Patients treated with contact low energy radiotherapy for a PMZCL or PCFCL from April 2009 to June 2017 in Saint Louis hospital were retrospectively analysed. Total dose ranged from 18 to 30 Gy. Objective response (OR) rates, DFS and OS as patterns of recurrence according to radiation fields were analysed. Univariate analysis of DFS has been performed according to clinical and biological parameters. Acute toxicity, long-term adverse events and satisfaction were collected via individualized questionnaires.

RESULTS:

Forty-six patients were included. Median follow-up was 43.5 months. OR was achieved for 100% of cases. Recurrence occurred in 39% of cases. Median DFS was 44 months. Three-year DFS and 5-year DFS were 56% and 51%, respectively. OS at 3 and 5 year was 100%. Only sex was significantly associated with DFS. Acute AEs occurred in 48% of cases without grade 3 and 4. 55% reported some moderate aesthetic sequelae for long-term AEs. 97% were satisfied with treatment.

CONCLUSION:

This study confirms the good risk-benefit of radiotherapy for the treatment of primary cutaneous indolent B-cell lymphomas due to the high response rate and a long DFS. No significant factor for recurrence was identified, except female sex. Long-term aesthetic evaluation was good or excellent for most of the patients.

• Authors: M-L Gauci, L Quero, C Ram-Wolff, S Guillerm, B M'Barek, C Lebbé, M Bagot, C Hennequin
• Journal: Journal of the European Academy of Dermatology and Venereology : JEADV (J Eur Acad Dermatol Venereol) Vol. 32 Issue 10 Pg. 1668-1673 (Oct 2018) ISSN: 1468-3083 [Electronic] England
• PMID: 29578630 (Publication Type: Journal Article, Review)
• Copyright: © 2018 European Academy of Dermatology and Venereology.

Topics

• Adult
• Aged
• Disease-Free Survival
• Follow-Up Studies
• Humans
• Lymphoma, B-Cell, Marginal Zone (radiotherapy)
• Lymphoma, Follicular (radiotherapy)
• Middle Aged
• Neoplasm Recurrence, Local
• Patient Satisfaction
• Radiotherapy (adverse effects)
• Retrospective Studies
• Sex Factors
• Skin Neoplasms (radiotherapy)
• Survival Rate
• Young Adult