Cancer Res Treat.  2025 Apr;57(2):570-579. 10.4143/crt.2024.651.

Long-term Clinical Efficacy of Radiotherapy for Patients with Stage I-II Gastric Extranodal Marginal Zone B-Cell Lymphoma of Mucosa-Associated Lymphoid Tissue: A Retrospective Multi-institutional Study

• Jeong JU
• Lee HC
• Song JH
• Eom KY
• Kim JH
• Kwak YK
• Kim WC
• Lee SY
• Choi JH
• Lee KK
• Lee JH

• KMID: 2566873
• DOI: http://doi.org/10.4143/crt.2024.651

Abstract

Purpose
This study aimed to evaluate long-term treatment outcomes in patients with localized gastric mucosa-associated lymphoid tissue (MALT) lymphoma treated with radiotherapy (RT).
Materials and Methods
A total of 229 patients who received RT in 10 tertiary hospitals between 2010 and 2019 were included in this multicenter analysis. Response after RT was based on esophagogastroduodenoscopy after RT. Locoregional relapse-free survival (LRFS) and disease-free survival (DFS), and overall survival (OS) were evaluated.
Results
After a median follow-up time of 93.2 months, 5-year LRFS, DFS, and OS rates were 92.8%, 90.4%, and 96.1%, respectively. LRFS, DFS, and OS rates at 10 years were 90.3%, 87.7%, and 92.8%, respectively. Of 229 patients, 228 patients (99.6%) achieved complete remission after RT. Five-year LRFS was significantly lower in patients with stage IIE than in those with stage IE (77.4% vs. 94.2%, p=0.047). Patients with age ≥ 60 had significantly lower LRFS than patients with age < 60 (89.3% vs. 95.1%, p=0.003). In the multivariate analysis, old age (≥ 60 years) was a poor prognostic factor for LRFS (hazard ratio, 3.72; confidence interval, 1.38 to 10.03; p=0.009). Grade 2 or higher gastritis was reported in 69 patients (30.1%). Secondary malignancies including gastric adenocarcinoma, malignant lymphoma, lung cancer, breast cancer, and prostate cancer were observed in 11 patients (4.8%) after RT.
Conclusion
Patients treated with RT for localized gastric MALT lymphoma showed favorable 10-year outcomes. Radiation therapy is an effective treatment without an increased risk of secondary cancer. The toxicity for RT to the stomach is not high.

Keyword

Radiotherapy; Efficacy; Muscosa; Stomach; Lymphoma

Figure

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  Fig. 1. Clinical response of extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue according to the status of Helicobacter pylori (HP) infection and eradication treatment. CR, complete response; PR-SD, partial response or stable disease.

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  Fig. 2. Locoregional relapse-free survival (A), disease-free survival (B), and overall survival (C) of entire patients.

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  Fig. 3. Locoregional relapse-free survival (A), disease-free survival (B), and overall survival (C) according to the patient’s age.

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