Effectiveness of low-dose radiation for primary cutaneous anaplastic large cell lymphoma

Grace L. Smith, MD, PhD, MPH; Madeleine Duvic, MD; Zeinab Abou Yehia, MD; Pamela Allen, PhD; Naveen Garg, MD; Tina Suki, BA; Sarah A. Milgrom, MD; Chelsea C. Pinnix, MD, PhD; Yasuhiro Oki, MD; Joseph D. Khoury, MD; Bouthaina S. Dabaja, MD

doi:10.1016/j.adro.2017.06.004

Advances in Radiation Oncology (Jul 2017)

Effectiveness of low-dose radiation for primary cutaneous anaplastic large cell lymphoma

Grace L. Smith, MD, PhD, MPH,
Madeleine Duvic, MD,
Zeinab Abou Yehia, MD,
Pamela Allen, PhD,
Naveen Garg, MD,
Tina Suki, BA,
Sarah A. Milgrom, MD,
Chelsea C. Pinnix, MD, PhD,
Yasuhiro Oki, MD,
Joseph D. Khoury, MD,
Bouthaina S. Dabaja, MD

Affiliations

Grace L. Smith, MD, PhD, MPH: Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
Madeleine Duvic, MD: Department of Dermatology, The University of Texas MD Anderson Cancer Center, Houston, Texas
Zeinab Abou Yehia, MD: Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
Pamela Allen, PhD: Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
Naveen Garg, MD: Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, Houston, Texas
Tina Suki, BA: Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
Sarah A. Milgrom, MD: Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
Chelsea C. Pinnix, MD, PhD: Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
Yasuhiro Oki, MD: Department of Lymphoma and Myeloma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
Joseph D. Khoury, MD: Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, Texas
Bouthaina S. Dabaja, MD: Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas

DOI: https://doi.org/10.1016/j.adro.2017.06.004
Journal volume & issue: Vol. 2, no. 3
pp. 363 – 369

Abstract

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Purpose: Primary cutaneous anaplastic large cell lymphoma (pcALCL) is conventionally treated with radiation therapy (RT) doses ≥30 GGy, but effectiveness of lower doses is unclear. We compared responses after a range of RT doses for pcALCL. Methods and materials: From 1999 through 2015, 45 lesions in 21 patients met clinicopathologic pcALCL diagnostic criteria and were treated with RT (<20 Gy, 20-29 Gy, or ≥30 Gy dose). Complete clinical (CR) and partial responses (PR) were compared by dose using Fisher exact test. Progression-free and overall survivals were calculated using the Kaplan-Meier method. Results: Forty-two percent of lesions were treated with <20 Gy, 22% with 20 to 29 Gy, and 35% with ≥30 Gy. Within 12 weeks, 100% responded, with 67% CR and 33% PR; by last follow-up, 87% achieved CR and 13% PR (no difference by RT dose; P = .84). Three-year freedom from local relapse was 100%, 86%, and 100% with <20 Gy, 20 to 29 Gy, and ≥30 Gy, respectively (P = .28). Many patients ultimately demonstrated other cutaneous or systemic relapse, with 55% 3-year and 29% 10-year progression-free survival. Overall survival at 10 years was 59%, with 2 deaths from complications of disease. Conclusions: Low-dose RT offered excellent local control in the setting of the indolent, chronic course of pcALCL in this patient cohort.

Published in Advances in Radiation Oncology

ISSN: 2452-1094 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Medicine (General): Medical physics. Medical radiology. Nuclear medicine; Medicine: Internal medicine: Neoplasms. Tumors. Oncology. Including cancer and carcinogens
Website: http://www.journals.elsevier.com/advances-in-radiation-oncology/

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