Radiat Oncol J.  2016 Dec;34(4):273-279. 10.3857/roj.2016.01781.

Analysis of treatment outcomes for primary tonsillar lymphoma

Affiliations
  • 1Department of Radiation Oncology, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Korea.
  • 2Department of Hematology, Catholic University Lymphoma Group (CULG), Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
  • 3Department of Radiology, Catholic University Lymphoma Group (CULG), Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
  • 4Department of Nuclear Medicine, Catholic University Lymphoma Group (CULG), Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
  • 5Department of Pathology, Catholic University Lymphoma Group (CULG), Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
  • 6Department of Ophthalmology, Catholic University Lymphoma Group (CULG), Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
  • 7Department of Internal Medicine, Catholic University Lymphoma Group (CULG), Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
  • 8Department of Radiation Oncology, Catholic University Lymphoma Group (CULG), Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea. choibo67@catholic.ac.kr

Abstract

PURPOSE
Although each Waldeyer's ring sub-site is considered an independent prognostic factor, few studies have assessed the prognosis and treatment of tonsillar lymphoma. Treatment outcomes were analyzed in patients with primary tonsillar lymphoma who were treated with chemotherapy and radiotherapy (RT).
MATERIALS AND METHODS
Nineteen patients with diffuse large B-cell lymphoma were evaluated, with a median follow-up of 53 months. Age, sex, and histology, amongst other factors, were reviewed. Progression-free survival (PFS) and overall survival (OS) rates were analyzed.
RESULTS
Most patients had Ann Arbor stage I-II (94.7%), IPI score of 0 (89.5%), and complete remission after chemotherapy (89.5%). The 5-year PFS and OS rates were 74.6% and 80%, respectively. In univariate analysis, the rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) regimen resulted in a better PFS than the cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) regimen (88.9% vs. 50.0%; p = 0.053). RT dose was related to the survival outcome (p = 0.010 for PFS, p = 0.044 for OS). Patients were classified into the CHOP + RT (>40 Gy) group and R-CHOP + RT (≤40 Gy) group. The 5-year PFS rates were 50% in the CHOP + RT group, and 100 % in the R-CHOP + RT group (p = 0.018). The 5-year OS rates were 66.7% and 100%, respectively (p = 0.087).
CONCLUSION
Primary tonsillar lymphoma patients typically have favorable outcomes. Chemotherapy (R-CHOP) combined with relatively lower dose consolidative RT may be safe and effective for primary tonsillar lymphoma.

Keyword

Palatine Tonsil; Non-Hodgkin lymphoma; Radiotherapy

MeSH Terms

Cyclophosphamide
Disease-Free Survival
Doxorubicin
Drug Therapy
Follow-Up Studies
Humans
Lymphoma*
Lymphoma, B-Cell
Lymphoma, Non-Hodgkin
Palatine Tonsil
Prednisone
Prognosis
Radiotherapy
Rituximab
Vincristine
Cyclophosphamide
Doxorubicin
Prednisone
Rituximab
Vincristine
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