Radiation therapy for the management of patients with HTLV-1-associated adult T-cell leukemia/lymphoma
Menée sur 10 patients atteints d'une leucémie à cellules T ou d'un lymphome associés au virus T-lymphotropique humain et ayant reçu un traitement systémique, cette étude évalue, du point de vue de la survie, l'efficacité et la toxicité d'une radiothérapie pour contrôler localement des lésions tumorales cutanées, ganglionnaires et extra-ganglionnaires (durée moyenne de suivi : 9 mois)
HTLV-1-associated adult T-cell leukemia/lymphoma (ATL) typically demonstrates survivals measured in months with chemotherapy. One prior published series (1983-1991) assessed local radiotherapy for ATL. Ten consecutive patients with pathologically-confirmed ATL treated with radiotherapy were reviewed. Subtypes included acute (n=7), smoldering (n=2), and lymphomatous (n=1). Patients received an average of 2.5 systemic therapy regimens prior to radiotherapy. Twenty lesions (cutaneous=10, nodal=8, extranodal=2) were treated to a mean of 35.4Gy/2-3Gy (range, 12-60Gy). At 9.0-month mean follow-up (0.1-42.0 months), all lesions symptomatically and radiographically responded, with in-field complete responses in 40.0% (nodal 37.5% vs. cutaneous 50.0%, p=0.62). No patient experienced in-field progression. Nine patients developed new/progressive out-of-field disease. Median survival was 17.0 months (3-year survival 30.0%). No RTOG acute grade ≥3 or any late toxicity was noted. This report is the first using modern radiotherapy techniques and demonstrates effective local control across ATL subtypes. Radiotherapy should be considered for symptomatic local progression of ATL.