Low-grade malt lymphoma of the stomach: A review of treatment options

Purpose: Low-grade mucosa-associated lymphoid tissue (MALT) lymphoma of the stomach (MLS) is often associated with the presence of Helicobacter pylori (H. pylori) bacteria, Eradication of the infection,vith antibiotic therapy may result in regression of the lymphoma. But when antibiotic treatment fa ils to reverse the malignant process or if H, pylori is absent, other treat ment options should be considered. Because MLS is often confined to the sto mach and regional lymph nodes, it is potentially curable with local therapy . Endoscopy and improved imaging, with endoscopic ultrasound (EUS) and comp uterized tomography (CT), have reduced the prior dependence on surgery for diagnosis and staging of gastric lymphomas. Methods and Results: This review details the advances in the diagnosis, cla ssification, and imaging of MLS. We also describe the experience that suppo rts the use of radiation therapy as the preferred treatment of MLS in patie nts who have not responded to antibiotic therapy or have not had evidence f or H, pylori infection, Conclusions: Radiation therapy for MLS is not only effective and safe, but offers the significant advantage of low mobidity and gastric function prese rvation. (C) 2000 Elsevier Science Inc.