Hypofractionated radiotherapy for refractory or relapsed aggressive B-cell lymphoma in the rituximab era.

Jan 15, 2024

Experts: 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

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.
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.
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.
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.

© 2024. The Author(s).

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ABOUT THE EXPERTS

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

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, Fuzhou, 350001, P. R. China.

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, Fuzhou, 350001, P. R. China.

Yan-Yan Qiu

Department of Hematology, Fujian Provincial Key Laboratory On Hematology, Fujian Medical University Union Hospital, Fujian Institute of Hematology, Fuzhou, P. R. China.

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, Fuzhou, 350001, P. R. China.

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, Fuzhou, 350001, P. R. China.

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, Fuzhou, 350001, P. R. China.

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, Fuzhou, 350001, P. R. China.

Si-Qin Liao

Department of PET/CT, Fujian Medical University Union Hospital, Fuzhou, P. R. China.

Jin-Hua Chen

Follow-Up Center, Fujian Medical University Union Hospital, Fuzhou, P. R. China.

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, Fuzhou, P. R. China.

Jian-Zhi Liu

Department of Otorhinolaryngology, Fujian Medical University Union Hospital, Fuzhou, P. R. China.

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, Fuzhou, 350001, P. R. China.

Ting-Bo Liu

Department of Hematology, Fujian Provincial Key Laboratory On Hematology, Fujian Medical University Union Hospital, Fujian Institute of Hematology, Fuzhou, P. R. China. 13706998835@139.com.

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, Fuzhou, 350001, P. R. China. dr_yangyong1983@163.com.