Annals of Oncology 14:1555-1561, 2003
© 2003 European Society for Medical Oncology
Original Paper |
Limited-stage mantle-cell lymphoma
Divisions of 1 Medical Oncology, 2 Pathology and Laboratory Medicine and 3 Radiation Oncology, British Columbia Cancer Agency, University of British Columbia, Vancouver, British Columbia, Canada
Received 29 January 2003; revised 27 April 2003; accepted 17 June 2003
Background:
Mantle-cell lymphoma (MCL) is known to have a poor outcome, however, most patients present with advanced-stage disease. Little information is available on limited-stage MCL.
Patients and methods:
We retrospectively reviewed clinicopathological information on all patients with limited-stage MCL seen at the British Columbia Cancer Agency since 1984.
Results:
Twenty-six patients had low bulk (<10 cm) stage IA (12 patients) or IIA (14 patients) MCL. Initial therapy was involved-field radiation therapy (RT) with or without chemotherapy (CT), 17 patients; CT alone or observation, nine patients. Fifteen patients are alive at a median follow-up of 72 months (range 14–194). Progression-free survival (PFS) at 2 and 5 years was 65% and 46%, and overall survival (OS) 86% and 70%, respectively. Five patients surviving beyond 8 years. Only age and initial use of RT significantly affected PFS. Five-year PFS for patients <60 years of age was 83%, compared with 39% for those aged 
60 years, P = 0.04. Patients receiving RT with or without CT (n = 17), had a 5-year PFS of 68%, compared with 11% for those not receiving RT (n = 9, P = 0.002). Receiving RT eliminated the impact of age on PFS (with RT the 5-year PFS was 83% for those aged <60 years and 57% for those 60 years, P = 0.17). Although OS for the whole group was 53% at 6 years, it was 71% for those initially treated with RT, but only 25% for those not given RT (P = 0.13).
Conclusion:
In our experience, patients with limited-stage MCL had an improved PFS when treated with regimens including RT, with a trend towards improved OS. These results suggest a potentially important role for RT in limited-stage MCL.
Key words: chemotherapy, limited-stage mantle-cell lymphoma, non-Hodgkin’s lymphoma, radiation therapy
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