The Role of Radiotherapy in the Treatment of Gastric Mucosa-Associated Lymphoid Tissue Lymphoma

다국어 초록 (Multilingual Abstract)

PurposeTo assess radiotherapy for patients with early stage gastric mucosa-associatedlymphoid tissue (MALT) lymphoma with respect to survival, treatment response, andcomplications.

Materials and MethodsEnrolled into this study were 48 patients diagnosed with gastric MALT lymphoma fromJanuary 2000 to September 2012. Forty-one patients had low grade and seven hadmixed component with high grade. Helicobacter pylori eradication was performed in33 patients. Thirty-four patients received radiotherapy alone. Ten patients receivedchemotherapy before radiotherapy, and three patients underwent surgery followedby chemotherapy and radiotherapy. One patient received surgery followed by radiotherapy.

All patients received radiotherapy of median dose of 30.6 Gy.

ResultsThe duration of follow-up ranged from 6 to 158 months (median, 48 months).

Five-year overall survival and cause-specific survival rates were 90.3% and 100%. Allpatients treated with radiotherapy alone achieved pathologic complete remission(pCR) in 31 of the low-grade and in three of the mixed-grade patients. All patientstreated with chemotherapy and/or surgery prior to radiotherapy achieved pCR exceptone patient who received chemotherapy before radiotherapy. During the follow-upperiod, three patients developed diffuse large B-cell lymphoma in the stomach, andone developed gastric adenocarcinoma after radiotherapy. No grade 3 or higher acuteor late complications developed. One patient, who initially exhibited gastroptosis,developed mild atrophy of left kidney.

ConclusionThese findings indicate that a modest dose of radiotherapy alone can achieve a highcure rate for low-grade and even mixed-grade gastric MALT lymphoma without serioustoxicity. Patients should be carefully observed after radiotherapy to screen forsecondary malignancies.

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