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Annals of Oncology Advance Access published online on December 11, 2008
Annals of Oncology, 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

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.

chemotherapy, gastric MALT lymphoma, Helicobacter pylori, radiotherapy

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


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