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11.03.2019 | Original Article

Favorable radiation field decrease in gastric marginal zone lymphoma

Experience of the German Study Group on Gastrointestinal Lymphoma (DSGL)

verfasst von: Gabriele Reinartz, Regina P. Pyra, Georg Lenz, Rüdiger Liersch, Georg Stüben, Oliver Micke, Kay Willborn, Clemens F. Hess, Andreas Probst, Rainer Fietkau, Ralf Jany, Jürgen Schultze, Christian Rübe, Carsten Hirt, Wolfgang Fischbach, Martin Bentz, Severin Daum, Christiane Pott, Markus Tiemann, Peter Möller, Andreas Neubauer, Martin Wilhelm, Normann Willich, Wolfgang E. Berdel, Hans T. Eich

Erschienen in: Strahlentherapie und Onkologie | Ausgabe 6/2019

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Abstract

Purpose

Long-term impact of stage-adapted field reduction in a large cohort of gastric marginal zone lymphoma (gMZL) patients treated conservatively with curative radiation therapy (RT).

Patients and methods

Prospective analysis of paper records of 290 patients with stage IE–IIE gMZL, treated in 78 radiotherapeutic institutions in Germany from 1992–2013. Stage-adapted radiation fields decreased from extended field (EF) to involved field (IF) over the course of three consecutive prospective trials of the German Study Group on Gastrointestinal Lymphoma (DSGL). Treatment results were compared between the three cohorts.

Results

Overall collective with median age of 60 years, slight male predominance (m:f = 1.1:1) and ratio of disease stage I:stage II = 2.1:1. Median follow-up 6.4 years in total: 13.0 years in the first gastrointestinal study (GIT 1992), 8.2 years in the second (GIT 1996) and 4.7 years in the third study (DSGL 01/2003). Stage-adapted radiation field decrease together with further technological development led to reduced relative frequencies of acute/chronic adverse effects and until now was accompanied by lower disease recurrence. The third study design with smallest field size (IF in stage I, locoregional EF in stage II) achieved the best survival outcome at the 5‑year follow-up (overall survival 92.7%, event-free survival 89.5% and lymphoma-specific survival 100.0%). Disease relapse observed in 10 patients. Cumulative incidence of disease-specific death was 1.7% of the followed patients. Primary disease stage associated with lymphoma-specific survival.

Conclusion

Stage-adapted reduction towards IF in gMZL resulted in favorable adverse effects, local control and survival rates. These results support further decreases in modern RT of gMZL.

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Titel: Favorable radiation field decrease in gastric marginal zone lymphoma
Experience of the German Study Group on Gastrointestinal Lymphoma (DSGL)
verfasst von: Gabriele Reinartz
Regina P. Pyra
Georg Lenz
Rüdiger Liersch
Georg Stüben
Oliver Micke
Kay Willborn
Clemens F. Hess
Andreas Probst
Rainer Fietkau
Ralf Jany
Jürgen Schultze
Christian Rübe
Carsten Hirt
Wolfgang Fischbach
Martin Bentz
Severin Daum
Christiane Pott
Markus Tiemann
Peter Möller
Andreas Neubauer
Martin Wilhelm
Normann Willich
Wolfgang E. Berdel
Hans T. Eich
Publikationsdatum: 11.03.2019
Verlag: Springer Berlin Heidelberg
Erschienen in: Strahlentherapie und Onkologie / Ausgabe 6/2019
Print ISSN: 0179-7158
Elektronische ISSN: 1439-099X
DOI: https://doi.org/10.1007/s00066-019-01446-5

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Springer Medizin

Favorable radiation field decrease in gastric marginal zone lymphoma

Experience of the German Study Group on Gastrointestinal Lymphoma (DSGL)

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Purpose

Patients and methods

Results

Conclusion

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Conclusion

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