Result of Radiation Therapy for Stage I, II Non-Hodgkin's Lymphoma

Lee, Kyuchan; Kim, Chul Yong; Choi, Myung Sun

Abstract

A retrospective analysis was done for 69 patients with Stage I and II non-Hodgkin's lymphoma who were treated from May 1981 to December 1990, in the Department of Radiadtion Oncology, Korea University Hospital. We used Ann Arbor Staging system and Working Formulation for histological classification. Forty-three patients(43/69, 62.3%) were Stage I and 26 patients (26/69, 37.7%) were Stage II, and B symptom was found in 10.1%(7/69). Nodal lymphoma was 21.7%(15/69); 14 patients with supradiaphragmatic disease and 1 patient with infradiaphragmatic disease. Extranodal lymphoma was 78.3%(54/69); 64.8%(35/54) for head and neck, 25.9%(14/54) for gastrointestinal tract. Histologically, low grade consists of 8.7%(6/69), intermediate grade 84.2%(56/69), high grade 10.1%(7/69), and diffuse large cell type was the most frequent form with 36 patients (36/69, 52.2%). Eighteen patients(26.1%) were treated with radiation therapy alone, 20 patients(29.0%) with radiation therapy combined with chemotherapy, 15 patients(21.7%) with radiation therapy combined with surgery and chemotherapy. Median survival duration was 28 months, and the range of survival time was from 1 Month to 134 months. Overall five-year survival rate for Stage I and II disease was 54.2%, with 64.5% for Stage I and 37.1% for Stage II. For nodal lymphoma, 5-year survival rate was 45.9%, and 56.5% for extranodal lymphoma; 60.0% for head and neck, 52.5% for GI tract primary disease. Local control rate for all patients was 88.4%(61/69), with 80% (12/15) for nodal lymphoma and 90.7%(49/54) for extranodal lymphoma. The total failure rate was 34.8%(24/69). Five of 24 (20.8%) patients who were failed developed local failure only, 12.5%(3/24) local failure with distant failure, and distant failure only were found in 66.7%(16/24). Between nodal lymphoma and extranodal lymphoma, there was no significant survival difference, but extranodal lymphoma showed higher incidence.