Radiation Therapy for Stage I Primary Orbital Non-Hodgkin's Lymphomas

1997 ◽  
Vol 83 (5) ◽  
pp. 822-825 ◽  
Author(s):  
Haldun Şükrü Erkal ◽  
Meltem Serin ◽  
Serpil Dizbay Sak ◽  
Ahmet Çakmak
Keyword(s):  
Radiation Therapy ◽  
Combination Chemotherapy ◽  
Disease Free Survival ◽  
Stage I ◽  
Entire Group ◽  
Low Grade ◽  
Intermediate Grade ◽  
Chop Regimen ◽  
Survival Probabilities ◽  
Hodgkin's Lymphomas

Aims and Background The orbit is an uncommon primary site for non-Hodgkin's lymphomas (NHL), and it accounts for less than 1% of all sites of primary presentations. We report the experience of the Department of Radiation Oncology at Ankara University Faculty of Medicine with radiation therapy in treatment of patients with stage I primary orbital NHL. Methods From February 1978 through August 1993, 14 patients with stage I primary orbital NHL were treated with radiation therapy. According to the Working Formulation classification, 8 patients had low-grade and 6 had intermediate-grade lymphomas. The most commonly used radiation therapy technique was a single anterior field with a Cobalt-60 unit, delivering 40 Gy in 2 Gy daily fractions. Two patients with intermediate-grade lymphomas received the CHOP regimen following radiation therapy. Results Follow-up ranged from 0.8 to 18.3 years (median, 10.3 years). Local control was achieved in all patients. Two patients with low-grade lymphomas relapsed locally and were successfully salvaged with radiation therapy. Three patients with intermediate-grade lymphomas failed systemically. Salvage therapy consisted of combination chemotherapy for 2 of them but was unsuccessful. Overall survival probabilities at 2, 5 and 10 years were 78.6%, 61.1% and 52.4%, respectively, for the entire group of 14 patients. Overall, cause-specific and disease-free survival probabilities were higher for patients with low-grade lymphomas than for those with intermediate-grade lymphomas (P = 0.03, P = 0.03 and P = 0.06, respectively). Cataracts were observed in 9 and lacrimal disorders in 4 patients. Conclusions The study suggests that among stage I primary orbital NHL, low-grade lymphomas could be treated with radiation therapy alone, whereas combination chemotherapy could accompany radiation therapy for intermediate-grade lymphomas.

scholarly journals Evaluation of grading systems in stage I lung adenocarcinomas: a retrospective cohort study

2017 ◽  
Vol 71 (2) ◽  
pp. 135-140 ◽  
Author(s):  
Tamás Zombori ◽  
József Furák ◽  
Tibor Nyári ◽  
Gábor Cserni ◽  
László Tiszlavicz
Keyword(s):  
Lung Adenocarcinoma ◽  
Disease Free Survival ◽  
Stage I ◽  
Low Grade ◽  
Intermediate Grade ◽  
Independent Prognostic Marker ◽  
Kaplan Meier ◽  
Grading Systems ◽  
Cox Proportional Hazard Regression ◽  
Resected Stage

AimsThere is no internationally accepted grading system for lung adenocarcinoma despite the new WHO classification. The architectural grade, the Kadota grade and the Sica score were evaluated and compared with overall (OS) and disease-free survival (DFS).MethodsComprehensive histological subtyping was used in a series of resected stage I lung adenocarcinoma to identify subtypes of adenocarcinomas, the architectural grade, the Kadota grade, the Sica grade, the mitotic count, nuclear atypia, the presence of lymphovascular, vascular and airway propagation, necrosis, and micropapillary or solid growth pattern in any percentage. Statistical models fitted included Kaplan-Meier estimates and Cox proportional hazard regression models.Results261 stage I adenocarcinomas were included. The 5-year survivals of different subtypes were as follows: lepidic (n=40, OS: 92.5%; DFS 91.6%), acinar (n=54, OS: 81.8%; DFS: 68.6%), papillary (n=49, OS: 73.6%; DFS: 61.0%), solid (n=95, OS: 64.7%; DFS: 57.8%) and micropapillary (n=23, OS: 34.8%; DFS: 33.5%). Concerning the architectural grade, there were significant differences between OS and DFS of low and intermediate (pOS=0.005, pDFS<0.001), low and high (pOS<0.001, pDFS<0.001) and intermediate and high grades (pOS=0.002, pDFS<0.001). Low-grade and intermediate grade tumours did not differ in survival according to Kadota grade and Sica grade. In the multivariable model, architectural grade was found to be an independent prognostic marker. In another model, architectural pattern proved to be superior to architectural grade.ConclusionsOf the three grading systems compared, the architectural grade makes the best distinction between the outcome of low-grade, intermediate-grade and high-grade stage I adenocarcinomas.

scholarly journals Treatment of low-grade and intermediate-grade lymphoma with intensive combination chemotherapy results in long-term, disease-free survival

Cancer ◽  
1990 ◽  
Vol 66 (4) ◽  
pp. 632-639 ◽  
Author(s):  
Jonathan D. Licht ◽  
Linda D. Bosserman ◽  
Janet W. Andersen ◽  
Beow Y. Yeap ◽  
Mary M. Klatt ◽  
...  
Keyword(s):  
Combination Chemotherapy ◽  
Disease Free Survival ◽  
Low Grade ◽  
Intermediate Grade ◽  
Free Survival ◽  
Disease Free

Treatment outcome and prognostic factors for primary nasal lymphoma.

1995 ◽  
Vol 13 (3) ◽  
pp. 666-670 ◽  
Author(s):  
R Liang ◽  
D Todd ◽  
T K Chan ◽  
E Chiu ◽  
A Lie ◽  
...  
Keyword(s):  
T Cell ◽  
Complete Remission ◽  
Combination Chemotherapy ◽  
Disease Free Survival ◽  
Stage I ◽  
Stage Iii ◽  
Chinese Patients ◽  
Low Grade ◽  
Bulky Disease ◽  
Nasal Lymphoma

PURPOSE To report our experience managing a large series of Chinese patients with primary nasal lymphoma. PATIENTS AND METHODS From January 1975 to December 1993, 100 patients (median age, 50 years) with newly diagnosed primary nasal lymphoma were studied. There were four low-grade, 62 intermediate-grade, nine high-grade, and 25 unclassifiable lymphomas. Immunophenotyping was performed in 45 patients: eight B cell, 35 T cell, and two uncertain. All cases of angiocentric lymphoma that were typed were T cell. Fifty-two patients had stage I disease, 15 had stage II, four had stage III, and 29 had stage IV. Only 15 patients had B symptoms (weight loss, night sweats, and/or fever), and 11 had bulky disease. Thirty-nine patients with clinically localized stage I and II disease received local radiotherapy alone (before 1980), and the remaining 28 stage I and II patients received combination chemotherapy followed by local radiotherapy. The 33 patients with advanced stage III and IV disease were given combination chemotherapy, and additional radiotherapy was given to five of them who had bulky local disease. RESULTS Significantly higher complete remission rates were observed in patients with early stages of disease and those without B symptoms. Superior disease-free survival after complete remission was observed in patients with stage I/II disease. Univariate factors associated with a better overall survival included age less than 60 years, stage I disease, and absence of B symptoms. Survival was significantly better in the subgroup of patients with stage I disease. CONCLUSION Patients with nasal lymphoma, especially those with advanced disease, seemed to have a poor prognosis, and their clinical outcome was not improved significantly by the use of chemotherapy instead of radiotherapy or the use of doxorubicin-containing chemotherapeutic regimens.

Combination Chemotherapy with Cyclophosphamide, Adriamycin, Vincristine and Prednisone (CHOP) for Non-Hodgkin's Lymphomas with Unfavorable Histology: Preliminary Results

1980 ◽  
Vol 66 (6) ◽  
pp. 749-756 ◽  
Author(s):  
Pasquale Cornelia ◽  
Giuseppe Abate ◽  
Giuseppe Cornelia ◽  
Giovanni S. Bruni ◽  
Donato Zarrilli ◽  
...  
Keyword(s):  
Complete Remission ◽  
Combination Chemotherapy ◽  
Remission Rate ◽  
Early Stage ◽  
Stage I ◽  
Bone Marrow Toxicity ◽  
Actuarial Survival ◽  
Actuarial Survival Rate ◽  
Moderate Nausea ◽  
Hodgkin's Lymphomas

From January 1978 to June 1979, 29 selected, previously untreated patients with unfavorable histology of non-Hodgkin's lymphomas (12 DPDL, 7 DM, 9 DH and 1 DU) were submitted to the combination chemotherapy CHOP (cyclophosphamide, 750 mg/m2 i.v. on day 1; adriamycin, 50 mg/m2 i.v. on day 1; vincristine, 1.4 mg/m2 i.v. on day 1, and prednisone, 100 mg p.o. on day 1 through 5) every 21 days. Eighteen patients were in early stage (I or II) and 11 of them were also submitted to involved field radiotherapy (60Co), immediately before (stage I) or during (stage II) the chemotherapy, with a mean dosage of 4,500 rad. The remaining 11 patients were in advanced stage (III or IV) of disease and were treated with chemotherapy alone. We obtained 20 complete remissions (68%), 8 partial remissions (28 %) and 1 no response (4 %) to therapy. Sixteen of 18 patients (89 %) in early stages and 4 of 11 patients (36 %) in advanced stages achieved a complete remission. The bone marrow toxicity of the chemotherapy was moderate. Nausea, vomiting and diarrhea were frequent but well controlled by the support therapy. The actuarial survival rate of patients, after 18 months of follow-up, is 41 % (40 % in complete remission). The patients who achieved a complete remission are all alive and 65 % of them still relapse free. We believe that the combination chemotherapy CHOP improves the complete remission rate as well as the survival of patients with unfavorable histology of non-Hodgkin's lymphomas.

Combination Chemotherapy (CVP or Chop)-Radiotherapy Approach in Early Stage Non-Hodgkin's Lymphomas

1982 ◽  
Vol 68 (2) ◽  
pp. 137-142 ◽  
Author(s):  
Pasquale Comella ◽  
Gianfranco Scoppa ◽  
Giuseppe Abate ◽  
Giuseppe Comella ◽  
Gaetano Apice ◽  
...  
Keyword(s):  
Combination Chemotherapy ◽  
Early Stage ◽  
Response To Therapy ◽  
Stage I ◽  
Stage Ii ◽  
Actuarial Survival ◽  
Favorable Histology ◽  
Significant Difference ◽  
Extended Field ◽  
Hodgkin's Lymphomas

From January 1978 to December 1980, 42 patients with early stage non-Hodgkin's lymphoma other than of the gastrointestinal tract were treated with radiotherapy and combination chemotherapy. Eighteen patients in stage I were submitted to locally extended-field radiotherapy up to a mean dose of 48 Gy with a Co60 source and, after a 3-week rest period, to 6 cycles of combination chemotherapy. Twenty-four patients in stage II received 3 cycles of combination chemotherapy before and after irradiation, the same as for stage I. Combination chemotherapy consisted of cyclophosphamide, vincristine and prednisone (CVP) for 15 cases with favorable histology (3 NWDL, 1 NPDI, 11 DWDL), whereas it included cyclophosphamide, adriamycin, vincristine and prednisone (CHOP) for 27 cases with unfavorable histology (20 DPDL, 3 DM, 4 DH). Complete remission (CR) was achieved in 35/42 (83%) patients, with a highly significant difference between stage I (100%) and stage II (71%). After 42 months of follow-up, the probability of survival for all patients was 72%. Survival was better for stage I (88%) than for stage II (68%) and for favorable histology (87%) as compared to unfavorable histology (70%). Furthermore, survival was highly influenced by response to therapy. Indeed, actuarial survival rate for CR was 91% as compared to a median survival time of 10.2 months for the remaining patients. Four patients, all with poor histology, relapsed after 5–24 (mean 11) months of CR. Only one of them had an extension in extranodal sites and eventually died, despite the salvage treatment utilized. In our experience, locally extended-field irradiation combined with chemotherapy gave a high proportion of CR and seemed to prevent relapses, particularly in extranodal sites.

Low-grade endometrial stromal sarcoma: a single center's experience with 22 cases

2008 ◽  
Vol 18 (5) ◽  
pp. 1084-1089 ◽  
Author(s):  
W. Y. Kim ◽  
J.-W. Lee ◽  
C. H. Choi ◽  
H. Kang ◽  
T.-J. Kim ◽  
...  
Keyword(s):  
Disease Free Survival ◽  
Endometrial Stromal Sarcoma ◽  
Disease Recurrence ◽  
Primary Treatment ◽  
Stage I ◽  
Low Grade ◽  
Stromal Sarcoma ◽  
Case Surgery ◽  
Abnormal Vaginal Bleeding ◽  
Disease Free

The aim of this retrospective study was to evaluate the clinical behavior and management outcome of low-grade endometrial stromal sarcoma (LGESS). From September 1994, to March 2007, 22 patients with histologically proven stage I LGESS were included in this study. Clinicopathologic variables, recurrence, and management outcomes were reviewed retrospectively. The median age of the 22 patients was 43 years. The most common presenting symptom was abnormal vaginal bleeding. All patients underwent a hysterectomy and had stage I disease. Six patients had adjuvant therapy after the hysterectomy. The median follow-up period was 77 months (range 12–202 months). Ten patients had disease recurrence. The median disease-free survival period was 111 months (range 6–182 months). The pelvis (eight cases) was the most common site of recurrence followed by the lung (four cases) and the liver (one case). Recurrent disease was treated with surgery (one case), surgery plus chemotherapy (five cases), chemotherapy (two cases), and surgery plus radiotherapy (two cases). Two patients died after 25 and 54 months after disease recurrence. Treatment with a bilateral salpingo-oophorectomy or adjuvant chemoradiation did not affect the disease-free interval. LGESS is usually a slow-growing neoplasm with an indolent clinical course. Surgery is the primary treatment for recurrent endometrial stromal sarcoma when feasible. Adjuvant treatment (radiotherapy, chemotherapy, or both) had no effect on the prognosis of patients with stage I disease

scholarly journals Stage I–II Low-grade Lymphomas: A prospective trial of combination chemotherapy and radiotherapy

1991 ◽  
Vol 2 ◽  
pp. 137-140 ◽  
Author(s):  
P. McLaughlin ◽  
L. Fuller ◽  
J. Redman ◽  
F. Hagemeister ◽  
E. Durr ◽  
...  
Keyword(s):  
Combination Chemotherapy ◽  
Prospective Trial ◽  
Stage I ◽  
Low Grade

Chemotherapy and radiation therapy in UPSC

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 5535-5535 ◽  
Author(s):  
A. Viswanathan ◽  
N. Horick ◽  
C. Tanaka ◽  
S. Campos ◽  
U. Matulonis ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Recurrence Rate ◽  
Disease Free Survival ◽  
Distant Metastases ◽  
Figo Stage ◽  
Median Number ◽  
Serous Carcinoma ◽  
Entire Group ◽  
Significant Difference ◽  
The Impact

5535 Purpose: To analyze the impact of chemotherapy (Ch) and radiation therapy (RT) on relapse rates in patients with uterine papillary serous carcinoma (UPSC). Materials and Methods: The outcomes of 160 women with UPSC seen between 1980–2005 at the BW/DFCC were analyzed. Exclusion criteria included stage IVB disease, no hysterectomy, unknown stage, or unknown type of RT. Results: The median age was 67 years (range 31–90). FIGO Stage was IA (21), IB (28), IC (13), IIA (7), IIB (10), IIIA (42), IIIB (2), IIIC (21), and IVA (16). Treatment included none (40), Ch alone (20), Ch and whole abdominal radiation (WA) (11), Ch and pelvic radiation (P) (30), Ch and vaginal brachytherapy (VB) (2), WA alone (24), P alone (19), and VB alone (14). The median dose of RT was WA 30 Gy and P 45 Gy. Ch was given to 63 patients; the median number of cycles of Carboplatin, Adriamycin and Paclitaxel was 3. Overall survival (OS) and disease-free survival (DFS) for the entire group were 67% and 57% at 2 years, 62% and 51% at 3 years and 51% and 38% at 5 years. A total of 58 patients relapsed. Among those who received no RT or Ch, 48% (19/40) relapsed; among those treated with Ch only, 50% (10/20) relapsed; in the group treated with RT only, 26% (15/57) relapsed; and, in those treated with Ch and RT, 33% (14/43) relapsed. A significant difference in recurrence rate was seen in patients treated with RT compared to those who received no treatment (OR 0.40, p=0.03). This difference persisted after controlling for Stage, which did significantly affect the relationship between RT treatment and recurrence. Local recurrence (in an RT field) was a component of failure for 14% (14/100) treated with RT, versus 42% (25/59) that received no RT (OR 0.22, p=0.0001). Distant metastases were a component of first failure in 15% (9/61) that received Ch versus 11% (11/97) that did not; there was no significant difference in distant recurrence rate for patients treated with Ch (OR 1.35, p=0.53). Conclusion: This single-institution study represents the largest series of UPSC to date. The use of RT significantly decreases the overall recurrence rate of UPSC in this series and should be considered in patients with stages I-IVA UPSC. Future studies looking at the optimal type, dose and duration of chemotherapy, as well as the use of novel agents, are needed to improve outcomes in this population. No significant financial relationships to disclose.

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