Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology · 2026
Optimizing low dose radiotherapy for indolent lymphomas: comparing 8 Gy in 2 fractions to 4 Gy in 2 fractions.
СтатьяСравнительное исследованиеНазвание и аннотация: Перевод в очереди
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Burlile Jessica F, Harmsen William S, Suddendorf Sydney D, Frechette Kelsey M, Saifi Omran, Kosydar Samuel R, Habermann Thomas M, Villasboas Bisneto J C C, Wang Yucai, Hampel Paul, Paludo Jonas, Hoppe Bradford S, Tao Randa, Ng Lydia, Aziz Khaled, Rule William G, Peterson Jennifer L, Witzig Thomas E, Micallef Ivana N, Breen William G, Lester Scott C
Аннотация
BACKGROUND AND PURPOSE: 4 Gy in 2 fractions has grown in use for indolent B-cell lymphomas because of its tolerance and convenience. However, local progression occurs in 30% of patients. In 2020, we introduced 8 Gy in 2 fractions with the hypothesis that this would improve control compared to 4 Gy in 2 fractions.
MATERIALS AND METHODS: We conducted a retrospective review of 121 patients (137 sites) with indolent lymphoma treated with either 4 Gy or 8 Gy in two fractions between 2013 and 2024 at a single institution. Local control and complete response were primary endpoints, assessed using imaging and clinical exam. Competing-risks analysis and Cox models were applied.
RESULTS: Median follow up for the overall cohort, 4 Gy cohort, and 8 Gy cohort was 2.9 years, 6.6 years, and 2.0 years respectively. Local progression occurred in 26% of sites treated with 4 Gy versus 7% with 8 Gy, and after appropriate censoring via univariate analysis, local control was superior with 8 Gy (HR 2.97, p = 0.044). Complete response at one year was also higher with 8 Gy (81%) than 4 Gy (57%) (HR 0.54, p = 0.001). On multivariable analysis, nodal sites of disease were independently associated with a higher rate of local recurrence, regardless of dose (HR 3.33, 1.13-8.86, p = 0.016).
CONCLUSION: Increasing the dose from 4 to 8 Gy was associated with a higher rate of local control while maintaining the convenience of 2 fractions. Further maturation of this data and results of ongoing prospective studies are needed.
MATERIALS AND METHODS: We conducted a retrospective review of 121 patients (137 sites) with indolent lymphoma treated with either 4 Gy or 8 Gy in two fractions between 2013 and 2024 at a single institution. Local control and complete response were primary endpoints, assessed using imaging and clinical exam. Competing-risks analysis and Cox models were applied.
RESULTS: Median follow up for the overall cohort, 4 Gy cohort, and 8 Gy cohort was 2.9 years, 6.6 years, and 2.0 years respectively. Local progression occurred in 26% of sites treated with 4 Gy versus 7% with 8 Gy, and after appropriate censoring via univariate analysis, local control was superior with 8 Gy (HR 2.97, p = 0.044). Complete response at one year was also higher with 8 Gy (81%) than 4 Gy (57%) (HR 0.54, p = 0.001). On multivariable analysis, nodal sites of disease were independently associated with a higher rate of local recurrence, regardless of dose (HR 3.33, 1.13-8.86, p = 0.016).
CONCLUSION: Increasing the dose from 4 to 8 Gy was associated with a higher rate of local control while maintaining the convenience of 2 fractions. Further maturation of this data and results of ongoing prospective studies are needed.