Chinese Academy of Medical Sciences and Peking Union Medical College Beijing, Aisa/Beijing
L. R. Gao1, X. Wang1, Y. Wu1, X. Feng2, W. Rao3, X. Liu4, Y. W. Song1, S. Wang1, S. Qi1, and Y. X. Li1; 1Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China, 2Department of Pathology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China, 3Department of Pathology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Beijing 100021, China, Beijing, China, 4Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Beijing, China
Purpose/Objective(s): This study aimed to access the disease failure patterns and optimal treatment of bronchus-associated lymphoid tissue (BALT) lymphoma. Materials/
Methods: This retrospective study involved 71 patients with BALT lymphoma who had received radiotherapy (RT), surgery, immunochemotherapy (IC), or observation. Overall survival (OS), lymphoma-specific survival (LSS), and progression-free survival (PFS) were analyzed. Cumulative disease failure incidence was determined using the competing risk regression model. The toxicities were evaluated using the Common Terminology Criteria for Adverse Events (CTCAE) 5.0 reporting system. Quality of life (QoL) was assessed using the EORTC QLQ-C30 questionnaire. Results: The median follow-up time was 66 months. The 5-year OS and LSS were 91.2% and 96.1%, respectively, and were not significantly different among treatments. Twenty patients (28.2%) experienced disease progression or relapse (5-year cumulative failure rate: 16.9%). PFS and incidence of failure were not significantly different between RT and surgery. However, RT versus IC and observation significantly decreased disease progression and relapse. The 5-year PFS rate for RT, surgery, IC, and observation was 100%, 72.9%, 66.6% (P = 0.040), and 63.8% (P = 0.045), respectively. The 5-year cumulative incidence of overall failure for RT, surgery, IC, and observation was 0%, 9.7% (P = 0.160), 30.8% (P = 0.017), and 31.3% (P = 0.039). RT had significantly lower cumulative incidence of locoregional failure than IC (21.1%, P = 0.020) and observation (31.3%, P = 0.036). There was no Grade =3 toxicity in RT group. The QoL was at similarly good levels among the treatment groups. Conclusion: BALT lymphoma had a favorable prognosis but persistent risk of relapse after IC or observation. Given the very low disease failure risk and good QoL, RT remains an effective initial treatment for BALT lymphoma.
