Hypofractionated radiotherapy for refractory or relapsed aggressive B-cell lymphoma in the rituximab era
Cheng Huang,
Tian-Lan Tang,
Yan-Yan Qiu,
Yu-Ping Lin,
Si-Lin Chen,
Rui-Zhi Zhao,
Gui-Qing Shi,
Si-Qin Liao,
Jin-Hua Chen,
Hai-Ying Fu,
Jian-Zhi Liu,
Ben-Hua Xu,
Ting-Bo Liu,
Yong Yang
Affiliations
Cheng Huang
Department of Radiation Oncology, Fujian Key Laboratory of Intelligent Imaging and Precision Radiotherapy for Tumors (Fujian Medical University), Clinical Research Center for Radiology and Radiotherapy of Fujian Province (Digestive, Hematological and Breast Malignancies ), Fujian Medical University Union Hospital
Tian-Lan Tang
Department of Radiation Oncology, Fujian Key Laboratory of Intelligent Imaging and Precision Radiotherapy for Tumors (Fujian Medical University), Clinical Research Center for Radiology and Radiotherapy of Fujian Province (Digestive, Hematological and Breast Malignancies ), Fujian Medical University Union Hospital
Yan-Yan Qiu
Department of Hematology, Fujian Provincial Key Laboratory On Hematology, Fujian Medical University Union Hospital, Fujian Institute of Hematology
Yu-Ping Lin
Department of Radiation Oncology, Fujian Key Laboratory of Intelligent Imaging and Precision Radiotherapy for Tumors (Fujian Medical University), Clinical Research Center for Radiology and Radiotherapy of Fujian Province (Digestive, Hematological and Breast Malignancies ), Fujian Medical University Union Hospital
Si-Lin Chen
Department of Radiation Oncology, Fujian Key Laboratory of Intelligent Imaging and Precision Radiotherapy for Tumors (Fujian Medical University), Clinical Research Center for Radiology and Radiotherapy of Fujian Province (Digestive, Hematological and Breast Malignancies ), Fujian Medical University Union Hospital
Rui-Zhi Zhao
Department of Radiation Oncology, Fujian Key Laboratory of Intelligent Imaging and Precision Radiotherapy for Tumors (Fujian Medical University), Clinical Research Center for Radiology and Radiotherapy of Fujian Province (Digestive, Hematological and Breast Malignancies ), Fujian Medical University Union Hospital
Gui-Qing Shi
Department of Radiation Oncology, Fujian Key Laboratory of Intelligent Imaging and Precision Radiotherapy for Tumors (Fujian Medical University), Clinical Research Center for Radiology and Radiotherapy of Fujian Province (Digestive, Hematological and Breast Malignancies ), Fujian Medical University Union Hospital
Si-Qin Liao
Department of PET/CT, Fujian Medical University Union Hospital
Jin-Hua Chen
Follow-Up Center, Fujian Medical University Union Hospital
Hai-Ying Fu
Department of Hematology, The Third Affiliated People’s Hospital of Fujian University of Traditional Chinese Medicine, The Third People’s Hospital of Fujian Province
Jian-Zhi Liu
Department of Otorhinolaryngology, Fujian Medical University Union Hospital
Ben-Hua Xu
Department of Radiation Oncology, Fujian Key Laboratory of Intelligent Imaging and Precision Radiotherapy for Tumors (Fujian Medical University), Clinical Research Center for Radiology and Radiotherapy of Fujian Province (Digestive, Hematological and Breast Malignancies ), Fujian Medical University Union Hospital
Ting-Bo Liu
Department of Hematology, Fujian Provincial Key Laboratory On Hematology, Fujian Medical University Union Hospital, Fujian Institute of Hematology
Yong Yang
Department of Radiation Oncology, Fujian Key Laboratory of Intelligent Imaging and Precision Radiotherapy for Tumors (Fujian Medical University), Clinical Research Center for Radiology and Radiotherapy of Fujian Province (Digestive, Hematological and Breast Malignancies ), Fujian Medical University Union Hospital
Abstract Background Radiotherapy (RT) is an effective and available local treatment for patients with refractory or relapsed (R/R) aggressive B-cell lymphomas. However, the value of hypofractionated RT in this setting has not been confirmed. Methods We retrospectively analyzed patients with R/R aggressive B-cell lymphoma who received hypofractionated RT between January 2020 and August 2022 at a single institution. The objective response rate (ORR), overall survival (OS), progression-free survival (PFS) and acute side effects were analyzed. Results A total of 30 patients were included. The median dose for residual disease was 36 Gy, at a dose per fraction of 2.3–5 Gy. After RT, the ORR and complete response (CR) rates were 90% and 80%, respectively. With a median follow-up of 10 months (range, 2–27 months), 10 patients (33.3%) experienced disease progression and three died. The 1-year OS and PFS rates for all patients were 81.8% and 66.3%, respectively. The majority (8/10) of post-RT progressions involved out-of-field relapses. Patients with relapsed diseases, no response to systemic therapy, multiple lesions at the time of RT, and no response to RT were associated with out-of-field relapses. PFS was associated with response to RT (P = 0.001) and numbers of residual sites (P < 0.001). No serious non-hematological adverse effects (≥ grade 3) associated with RT were reported. Conclusion These data suggest that hypofractionated RT was effective and tolerable for patients with R/R aggressive B-cell lymphoma, especially for those that exhibited localized residual disease.
