Radiation Therapy for Primary Cutaneous Anaplastic Large Cell Lymphoma (pcALCL): An International Lymphoma Radiation Oncology Group (ILROG) Multi-institutional Experience
Menée à partir de données portant sur 56 patients atteints d'un lymphome cutané anaplasique à grandes cellules, cette étude internationale évalue l'efficacité, du point de vue du taux de réponse complète, d'une radiothérapie en traitement de première ligne ou après une exérèse chirurgicale
Purpose : Primary cutaneous anaplastic large cell lymphoma (pcALCL) is a rare cutaneous T-cell lymphoma. Radiation therapy (RT) is often the primary modality of treatment. The purpose of this study is to collect response rates to RT to determine potential prognostic factors predictive of outcome. Methods and Materials : The study was a retrospective analysis of patients (pts) with pcALCL who received RT as primary therapy or following surgical excision. Data collected include: initial stage of disease, RT modality (electron/photon), total dose, fractionation, response to treatment, and local recurrence. RT was delivered at eight participating ILROG institutions worldwide. Results : 56 patients met the eligibility criteria and 63 tumors were treated: head/neck (27%), trunk (14%), upper extremities (27%) and lower extremities (32%). Median tumor size was 2.25 cm (range 0.6-12 cm). T classification included T1 - 40 patients (71%), T2 - 12 pts (21%), and T3 - 4 pts (7%). The median radiation dose was 35 Gy (range 6-45 Gy). Complete clinical response (CCR) was achieved in 60 of 63 tumors (95%) and partial response (PR) in 3 tumors (5%). After CCR, 1 tumor recurred locally (1.7%) after 36 Gy and 7 months after RT. This was the only patient to die of disease. Conclusions : pcALCL is a rare, indolent cutaneous lymphoma with a low death rate. This analysis, which was restricted to patients selected for treatment with radiation, indicates that achieving CCR was independent of radiation dose. As there were too few failures (<2%) for statistical analysis on dose response, 30 Gy appears to be adequate for local control, and even lower doses may suffice.