LONG-TERM RESULTS OF TOTAL ABDOMINOPELVIC IRRADIATION IN NON-HODGKINS-LYMPHOMAS AFTER FAILURE OF CHEMOTHERAPY

Purpose: To evaluate the therapeutic efficacy of moderate-dose total a bdominopelvic irradiation (TAI) in a retrospective series of pretreate d non-Hodgkin's lymphomas (NHL). Methods and Materials: From 1977 to 1 994, 45 patients received TAI after failure of chemotherapy (CT). Acco rding to the Working Formulation, 10 patients were diagnosed with clas s A (group I), 19 with class B, C, or D (follicular) (group II), and 1 6 with class E or more severe (group III) NHL. Irradiation consisted o f two daily fractions of 0.80 Gy each for a total dose of 20 Gy. Resul ts: Mean follow-up after TAI was 102 months (range 8-156). For the ent ire group, the complete response (CR) rate was 66%, the partial respon se (PR) rate 29%, 10-year overall survival (OS) 35%, 10-year disease-f ree survival (DFS) 29%, and median survival 32 months. When results be tween subgroups were compared, CR was 70% in group I, 84% in group II, and 44% in group III; and survival was statistically higher in group II than in groups I and III: 10-year OS 52% vs. 10% (p < 0.01) and 31% (p < 0.05), respectively, 10-year DFS 37% vs. 10% (p < 0.03) and 19% (p < 0.05), respectively. Grade III or IV complications were gastroint estinal in 27% of patients and hematologic in 25%. Conclusion: Large-f ield irradiation in moderate doses could provide an alternative to bon e marrow transplantation in refractory NHL, especially in cases showin g a follicular growth pattern. (C) 1998 Elsevier Science Inc.