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Annals of Oncology Advance Access originally published online on December 11, 2008
Annals of Oncology 2009 20(3):465-468; doi:10.1093/annonc/mdn668
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© The Author 2008. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: journals.permissions@oxfordjournals.org

gastrointestinal tumors

Complete long-term response to radiotherapy of gastric early-stage marginal zone lymphoma resistant to both anti-Helicobacter pylori antibiotics and chemotherapy

P. G. Gobbi2,*, F. Corbella1, F. Valentino2, M. Bergonzi2, C. Sangalli1, V. Perfetti2 and G. R. Corazza2

1 Clinica Medica I, Università di Pavia and Servizio di Radioterapia Oncologica, Pavia
2 Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy

* Correspondence to: Prof. P. G. Gobbi, Clinica Medica I, Università di Pavia, Fondazione IRCCS Policlinico S. Matteo, P.le Golgi no. 2, 27100 Pavia, Italy. Tel: +39-0382-502954; Fax: +39-0382-526223; E-mail: gobbipg{at}smatteo.pv.it

Background: The optimal approach to patients with gastric lymphoma of extranodal mucosa-associated lymphoid tissue (MALT) that resist to anti-Helicobacter pylori (HP) eradication therapy is still to be defined.

Patients and methods: From January 1997 to December 2004, we observed 24 patients affected with newly diagnosed early-stage and HP-positive gastric lymphoma of the MALT type. Five of them resisted to oral anti-HP antibiotic regimens and to subsequent one (two patients) or two (three patients) chemotherapy regimens. Age ranged between 51 and 77 years (median 70); three were females. Translocation (11;18) was ascertained in one subject. They were admitted to local radiation therapy with a total dose of 30 Gy.

Results: All such resistant patients achieved complete remission after radiotherapy. No relapses were observed after 21, 45, 48, 52, and 67 months of uninterrupted follow-up. Early toxicity was very low and consisted of mild nausea. Late toxicity or secondary malignancy was not recorded so far.

Conclusions: Radiotherapy proved to be effective and safe for early-stage HP-positive gastric extranodal lymphoma of MALT type that is resistant to anti-HP eradication antibiotics and to following chemotherapy. Radiotherapy might be suggested as principal salvage therapy after resistance to HP eradication, instead of chemotherapy.

Key words: chemotherapy, gastric MALT lymphoma, Helicobacter pylori, radiotherapy

Received for publication September 2, 2008. Accepted for publication September 9, 2008.


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