Low-Dose Involved-Field Radiotherapy in Relapsed Low-Grade Non-Hodgkin's Lymphoma in Elderly Patients (Mansoura University Experience)

Purpose: To assess the response rate, duration of response and prognostic factors affecting response after low-dose involved-field radiotherapy in patients with relapsed low-grade B-cell non-Hodgkin lymphoma. Patients and Methods: Forty-four patients were included. Patients were treated with a total dose of 4 Gy (2 × 2 Gy) using 6 - 15 Mv photon or electron beam. Results: most patients were above age of 60 years (59%) with male predominance. Follicular lymphoma was the most common pathological type;bulky disease (>5 cm) was presented in 61.4%. Patients who received only 2 regimens were 63.7% and 31.8% had >2 involved sites. No treatment related toxicity was observed. The overall response rate was 88.7%;complete response was reached in 59.1% and stable disease in 6.8%, progressive disease in 4.5%. Median time to local progression was 33 months (95% CI 23.70 - 42.29);2-year local progression free survival was 78%. Response rate was found to be dependent on age, number of involved sites and lymph node size but independent on sex, pathological type, number of prior regimens, LDH level and time since diagnosis. Conclusion: Short-course-low dose palliative radiotherapy (2 × 2 Gy) affords an attractive option for treatment of relapsed low-grade non-Hodgkin’s lymphoma due to high response rates. However, these results had to be confirmed in a larger number of patients.

The feasibility and safety of high-intensity focused ultrasound combined with low-dose external beam radiotherapy as supplemental therapy for advanced prostate cancer following hormonal therapy

The aim of this study was to investigate the feasibility and safety of high-intensity focused ultrasound （HIFU） combined with （＋） low-dose external beam radiotherapy （LRT） as supplemental therapy for advanced prostate cancer （PCa） following hormonal therapy （HT）. Our definition of HIFU＋LRT refers to treating primary tumour lesions with HIFU in place of reduced field boost irradiation to the prostate, while retaining four-field box irradiation to the pelvis in conventional-dose external beam radiotherapy （CRT）. We performed a prospective, controlled and non-randomized study on 120 patients with advanced PCa after HT who received HIFU, CRT, HIFU＋LRT and HT alone, respectively. CT/MR imaging showed the primary tumours and pelvic lymph node metastases visibly shrank or even disappeared after HIFU ＋LRT treatment. There were significant differences among four groups with regard to overall survival （OS） and disease-specific survival （DSS） curves （P=0.018 and 0.015）. Further comparison between each pair of groups suggested that the long-term DSS of the H IFU ＋ LRT group was higher than those of the other three groups, but there was no significant difference between the HIFU＋LRT group and the CRT group. Multivariable Cox＇s proportional hazard model showed that both HIFU＋LRT and CRT were independently associated with DSS （P=0.001 and 0.035） and had protective effects with regard to the risk of death. Compared with CRT, HIFU ＋LRT significantly decreased incidences of radiation-related late gastrointestinal （GI） and genitourinary （GU） toxicity grade ≥ II. In conclusion, long-term survival of patients with advanced PCa benefited from strengthening local control of primary tumour and reRional lymph node metastases after HT. As an alternative to CRT, HIFU＋LRT showed Rood efficacy and better safety.

Mucosa-associated lymphoid tissue lymphoma of the trachea treated with radiotherapy:A case report

BACKGROUND Mucosa-associated lymphoid tissue(MALT)lymphoma originates in the marginal zone of lymphoid tissue.lung is one of the most frequent non-gastrointestinal organs involved,here known as bronchus-associated lymphoid tissue(BALT)lymphoma.BALT lymphoma of unknown etiology,and most patients are asymptomatic.The treatment of BALT lymphoma is controversial.CASE SUMMARY A 55-year-old man admitted to hospital had a three-month history of progressively coughing up yellow sputum,chest stuffiness,and shortness of breath.Fiberoptic bronchoscopy revealed mucosal visible beaded bumps 4 cm from the tracheal carina at 9 o'clock and 3 o'clock,the right main bronchus,and the right upper lobe bronchus.Biopsy specimens showed MALT lymphoma.Computed tomography virtual bronchoscopy(CTVB)showed uneven main bronchial wall thickening and multiple nodular protrusion.BALT lymphoma stage IE was diagnosed after a staging examination.We treated the patient with radiotherapy(RT)alone.A total dose of 30.6 Gy/17 f/25 d was given.The patient had no obvious adverse reactions during RT.The CTVB was repeated after RT and showed that the right side of the trachea was slightly thickened.CTVB was repeated 1.5 mo after RT and again showed that the right side of the trachea was slightly thickened.Annual CTVB showed no signs of recurrence.The patient now has no symptoms.CONCLUSION BALT lymphoma is an uncommon disease and shows good prognosis.The treatment of BALT lymphoma is controversial.In recent years,less invasive diagnostic and therapeutic approaches have been emerging.RT was effective and safe in our case.The use of CTVB could provide a noninvasive,repeatable,and accurate method in diagnosis and follow-up.

High-dose methotrexate and zanubrutinib combination therapy for primary central nervous system lymphoma

In this editorial I comment on the article,published in the current issue of the World Journal of Clinical Oncology.Primary central nervous system lymphoma(PCNSL)is a disease of elderly and immunocompromised patients.The authors reported clinical results of 19 patients with PCNSL treated with zanubrutinib/high dose methotrexate(HD-MTX)until disease progression.They demonstrated that the combination of zanubrutinib with HD-MTX led to a marked clinical response and tolerability among these patients.They also observed that cerebrospinal fluid liquid biopsy to detect circulating tumor DNA may be a good option for evaluating treatment response and tumor burden in patients with PCNSL.PCNSL is a challenging disease for treatment as these patients present with different neurological states and comorbidities.Treatment has evolved over the years from whole brain radiotherapy to HD-MTX followed by autologous stem cell transplant.Gradually,treatment of patients with PCNSL is going to become individualized.

The Clinical Pathologic Analysis of Radiotherapy for Cutaneous B-cell Lymphoma

OBJECTIVE To report results of radiation therapy treatment of 30 B-cell lymphoma patients with an initial cutaneous presentation according to the new classification by the WHO/EORTC. METHODS Thirty patients with cutaneous B-cell lymphoma （CBCL） were treated by cutaneous irradiation based on the number and location of the lesions and the stage of their tumor. Treatment was conducted using a Satume Clinac. RESULTS A complete response （CR） from the treatment for our series was 86%. The length of complete remission ranged from 4 to 301 months. Three patients （11%） developed a partial response （PR）. One patient was progressive. Disease-free survival（DFS） at 10 years was 87%. Three patiens died [One PCMZL two PCLBCL leg type （29%）]. Radiotherapy was generally well tolerated. CONCLUSION According to the WHO/EORTC classification, the survivor results were good for PCMZL and PCFCL. The PCLBCL leg type had a poor prognosis. Localized field irradiation is an effective treatment for some localized forms of primary cutaneous B-cell lymphoma, and this mode of therapy can produce prolonged remissions.The patients with wide-spread skin involvement are usually candidates for extended field irradiation and/or chemotherapy. For advanced stages of cutaneous B-cell lymphoma, where chemotherapy is the treatment of choice, a degree of palliation can be achieved using local field irradation.

Palliative Local Radiotherapy in the Treatment of Tumor-stage Cutaneous T-cell Lymphoma/ Mycosis Fungoides

Objective To determine the efficacy of palliative radiotherapy in treating tumor-stage cutaneous T-cell lymphoma/mycosis fungoides(MF).Methods From January 2008 to January 2013,a total of 11 patients with tumor-stage MF were treated with local radiation therapy in Peking Union Medical College Hospital.The median age of these patients was 53.36±14.45 years.Female-male ratio was 1:1.2.The average course of disease was 10.82±3.37 years.All the patients were treated with local electronic beam irradiation with a total median dosage of 48.55±9.51(40-74) Gy in an average of 24.55±5.57(20-40) fractions,5 fractions per week.Results The median follow-up time was 55.27±29.3(13-103) months.No severe acute or chronic side effects of irradiation were observed.Complete clinical response(CR) rate of the radiated sites was 54.5%(6/11),partial response(PR) rate was 36.4%(4/11),and the overall response rate(CR+PR) was 90.9%.One patient showed no response.Conclusion Local radiotherapy with psolaren plus ultraviolet A and/or interferon maintaining treatment is an effective palliative therapy in the treatment of tumor-stage MF patients.

Involved Nodal Radiotherapy vs. Involved Field Radiotherapy after Chemotherapy in the Treatment of Early Stage Hodgkin’s Lymphoma

Aim of work: This study is a prospective randomized trial aiming to investigate whether radiotherapy volume can be reduced without loss of efficacy from involved field radiotherapy (IFRT) to involved node radiotherapy (INRT) after four cycles of ABVD chemotherapy in the treatment of early stage Hodgkin’s lymphoma. Patients and Methods: Between September 2009 and January 2012, all patients with newly diagnosed early-stage favorable and unfavorable Hodgkin’s lymphoma attending to the Clinical Oncology department of Cairo University, faculty of medicine were enrolled into this study after a written consent was obtained from those cases enrolled. Patients were assigned to receive (ABVD) for four cycles followed by randomization for radiotherapy into two arms one arm of 30 Gy INRT +/– 6 Gy to residual disease or another arm of 30 Gy IFRT +/– 6 Gy to residual disease. Results: 35 patients were enrolled in this study: 16 patients in the INRT arm and 19 patients in the IFRT arm. The median observation time was 25 months. The overall survival for all eligible patients was 97% and freedom from treatment failure was 85.7%. Survival rates at the end of the study revealed no differences between INRT and IFRT arms. Also, in terms of complete remission post radiotherapy (14 versus 15), relapse (1 versus 4), and death (0 versus 1) respectively the outcome was similar in both arms. As regard acute and sub-acute toxicities no significant difference could be detected between both arms except that IFRT arm was associated with a higher incidence of radiation pneumonitis (4 versus 1 patient). Conclusion: Radiotherapy volume size reduction from IFRT to INRT after ABVD chemotherapy for four cycles produces similar results and less toxicity in patients with early-stage Hodgkin’s lymphoma especially in patients with mediastinal disease.

Radiotherapy for gastric mucosa-associated lymphoid tissue lymphoma

Gastric mucosa-associated lymphoid tissue(MALT)lymphoma is a rare disease which is often associated with Helicobacter pylori(H.pylori)infection.First-line treatment of stage IE and IIE localized gastric MALT lymphoma is based on the eradication of H.pylori.The presence of H.pylori resistance factors such as translocation t(11;18),peri-gastric lymph node involvement and the degree of tumor infiltration of the gastric wall;or lack of response to antibiotic therapy are two main indications to treat with definitive radiotherapy(RT).RT is an effective treatment in localized gastric MALT lymphoma.A moderate dose of 30 Gy allows a high cure rate while being well tolerated.After treatment,regular gastric endoscopic follow-up is necessary to detect a potential occurrence of gastric adenocarcinoma.

Three-dimensional conformal radiotherapy plus concurrent DICE chemotherapy for early-stage nasal-type natural killer/T-cell lymphoma of Waldeyer's ring: A single-institution study

Objective Nasal-type natural killer/T-cell lymphoma of Waldeyer＇s ring （WR-NK/TL） has different clinico- pathological characteristics from those of other subtypes of NK/T lymphoma; thus, the optimal treatment remains unclear. To find a more effective treatment model for WR-NK/TL, we conducted a single-center study of concurrent radiochemotherapy. Methods Forty-five patients with newly diagnosed stage IE to liE WR-NKTL were randomly divided into two groups. The 23 cases in the concurrent radiochemotherapy group were treated with three-dimensional conformal radiotherapy （48-52 Gy） and 2 courses of DICE （dexamethasone, ifosfamide, cisplatin, and etoposide） synchronous chemotherapy. The 22 cases in the radiotherapy group only received three-dimen- sional conformal radiotherapy （50-54 Gy）. The primary end points were overall survival （OS）, progression- free survival （PFS）, and toxicity. Results The 1-, 3-, and 4-year OS and PFS rates were 95.5%, 65.6%, and 45.9%, and 86.4%, 56.0%, and 46.7% in the radiotherapy group, and 100%, 88.5%, and 88.5%, and 100%, 82.0%, and 73.8% in the concurrent radiochemotherapy group, respectively. The OS （P = 0.0477） and PFS rates （P = 0.0488） were higher in the concurrent radiochemotherapy group than in the radiotherapy group. The overall re- sponse rate was 100% in both the radiotherapy group [complete response （CR）, 18 cases] and concurrent radiochemotherapy group （CR, 22 cases）. The concurrent radiochemotherapy group had more severe side effects, especially grade 3 ＋ 4 events, such as leukopenia, anorexia, and stomatitis. However, side effects benefiting from excellent oral care were endurable. Conclusion Radiotherapy plus concurrent DICE chemotherapy may be an effective and safe compre- hensive treatment for patients with WR-NKTL.

Post Radiotherapy “Isolated LP of the Lips” in a Non-Hodgkin Lymphoma Patient: A Possible Relation

We report upon a case of 62 years old Saudi male with non-Hodgkin lymphoma who developed lichen planus (LP) on the inner aspect of the upper lip six months after finishing radiotherapy. The diagnosis of LP was confirmed by histopathology. Literature review reveals few countable similar reports of “post radiotherapyoral LP (OLP)”. However, the isolated location of lichen planus on the upper lip per se in this case merits reporting being exceptional and reported before as isolated lichen planus of the lips (ILPL). We assume, after screening literature, that this is the first report of post radiotherapy ILPL in Arabian Gulf countries, though it may be underestimated and underreported. The etiological relation between radiotherapy and LP is discussed.

分层应变技术联合左心室压力-应变环对儿童胸部霍奇金淋巴瘤放疗后心肌损伤的评估价值

目的 分析采用分层应变技术和左心室压力-应变环(PSL)对胸部霍奇金淋巴瘤(HL)患儿放疗后心肌损伤的评估价值。方法 抽取2020年1月至2022年12月河南省肿瘤医院接受放疗的胸部HL患儿52例,所有患儿均在放疗前进行PSL及分层应变技术检查,并于放疗后进行心肌标志物与影像学检查,统计儿童放疗后心肌损伤发生情况,并根据结果分为心肌损伤组与非心肌损伤组。比较心肌损伤组与非心肌损伤组患者的PSL检测参数[做功指数(GWI)、整体有用功(GCW)、整体无用功(GWW)、整体做功效率(GWE)]、分层应变技术检测参数[心外膜层收缩期纵向峰值应变(LPS-epi)、中层纵向收缩期峰值应变(LPS-mid)、心内膜层纵向收缩期峰值应变(LPS-endo)],采用点二列相关性分析PSL与分层应变技术检查与胸部HL患儿放疗后心肌损伤的相关性,并绘制受试者工作特征(ROC)曲线,分析分层应变技术联合PSL对患儿放疗后心肌损伤的评估价值。结果 经过检查后发现,52例胸部HL患儿中出现心肌损伤占比61.54%,未出现占比38.46%;心肌损伤组GWI、GCW、GWW与GWE低于非心肌损伤组(P<0.05);心肌损伤组LPS-epi、LPS-mid与LPS-endo高于非心肌损伤组(P<0.05);经点二列相关性分析显示,GWI、GCW、GWW、GWE与胸部HL患儿放疗后心肌损伤呈负相关(r<0,P<0.05),LPS-epi、LPS-mid、LPS-endo与胸部HL患儿放疗后心肌损伤呈正相关(r>0,P<0.05);绘制ROC曲线,结果显示,分层应变技术联合PSL对胸部HL患儿放疗后心肌损伤发生的曲线下面积>0.7,联合具有一定的评估价值。结论 分层应变技术联合PSL在胸部HL患儿放疗后心肌损伤情况中具有重要的临床评估价值,能够有效评估患儿心肌损伤情况,为临床患儿的防治提供依据。

嵌合抗原受体T细胞与不同放疗方式协同治疗大肿块型淋巴瘤的研究

目的:探索不同放疗方式与嵌合抗原受体T(CAR-T)细胞协同治疗大肿块型淋巴瘤的疗效。方法:建立大肿块型淋巴瘤异种移植小鼠模型,使用低、中、高剂量的X射线对小鼠进行照射,测量照射后各组小鼠肿瘤体积的变化情况。再将低、中、高剂量的X射线分别与CAR-T细胞联用对小鼠进行治疗,记录不同的联用方式治疗后肿瘤体积的变化情况和各组小鼠的生存时间,使用流式细胞术检测各组小鼠外周血和肿瘤内CAR-T细胞占比的差异,观察治疗后各组小鼠的不良反应。结果:单纯X射线治疗无法控制巨块型淋巴瘤小鼠的肿瘤进展,而分别将低、中、高剂量的X射线与CAR-T细胞联用则均能使小鼠的肿瘤体积缩小。与低剂量联合组相比,中、高剂量联合组小鼠的肿瘤体积缩小更显著且未见重新增大的迹象(F组间=1052.364,F时间=14861.095,F交互=49.864,均P<0.001;组间均P<0.05),此外,中剂量联合组[HR=21.880(3.884~124.600),Log-rankχ^(2)=12.090,P<0.01]和高剂量联合组[HR=21.880(3.884~124.600),Log-rankχ^(2)=12.090,P<0.01]小鼠生存期也均明显延长。中、高剂量X射线可能更利于CAR-T细胞的瘤内浸润,与低剂量联合组相比,中(t=28.200,P<0.05)、高(t=23.960,P<0.05)剂量联合组在治疗后第14天的瘤内CAR-T细胞比例均明显增加。不同联用方式的不良反应大多在可耐受范围内。结论:与低剂量X射线相比,中、高剂量X射线能与CD19 CAR-T细胞协同更有效地治疗大肿块型淋巴瘤。

桥接治疗在大B细胞淋巴瘤CAR-T治疗中的应用进展

桥接治疗是嵌合抗原受体T细胞治疗(chimeric antigen receptor T cell therapy,CAR-T)过程中的一种补充性治疗方式,其为单个核细胞采集至CAR-T细胞回输期间进行的一种抗肿瘤治疗。桥接治疗能够一定程度上延缓大B细胞淋巴瘤(large B-cell lymphoma,LBCL)进展、降低肿瘤负荷,为CAR-T细胞的顺利回输提供保障。桥接治疗的方式包括化疗、放疗、靶向治疗等。其中,桥接放疗除了保障CAR-T细胞顺利回输,还有CAR-T治疗增敏作用。本文总结了LBCL CAR-T相关桥接治疗的意义、方式及特点,旨在对桥接治疗在LBCL CAR-T治疗中的应用提供参考。

Treatment outcome of localized Helicobacter pylori-negative low-grade gastric MALT lymphoma

AIM: To investigate treatment outcome of Helicobacter pylori (H.pylori )-negative low-grade gastric mucosaassociated lymphoid tissue (MALT) lymphoma.METHODS: In this study,we retrospectively reviewed the clinical outcome and clinicopathologic factors of stage Ⅰ E H.pylori -negative low-grade gastric MALT lymphoma cases from August 1998 to June 2009.RESULTS: A total of eleven patients with H.pylori -negative low-grade gastric MALT lymphoma were enrolled in the study and received anti-H.pylori eradication treatment and/or radiotherapy or excisional therapy.Complete remission (CR) of gastric MALT lymphoma was achieved in all patients.The time to CR was 1-66 mo (median,1 mo).CONCLUSION: Eradication therapy may be offered as an initial treatment option even in cases of localized H.pylori -negative gastric MALT lymphoma.

Clinical features, survival and prognostic factors of primary testicular diffuse large B-cell lymphoma

Objective： To assess the clinical features, survival and prognostic factors of primary testicular diffuse large B-cell lymphoma （DLBCL）. Methods： A retrospective study of 37 patients with primary testicular DLBCL was carried out from November 2003 to May 2012. Their clinical features, survival and prognostic factors were analyzed. Results： During a median follow-up period of 39.8 months （5.4-93.0 months）, the median progression-free survival （PFS） was 26.2 months （95% CI：0-65 months） and the 3-year overall survival （OS） rate was 78.4%. Within the whole cohort, the factors significantly associated with a superior PFS were limited stage （stage Ⅰ/Ⅱ）, lactate dehydrogenase （LDH） ≤245 U/L, international prognostic index （IPI） ≤1, primary tumor diameter 〈7.5 cm, and patients who had complete response （CR） and received doxoruhicin-contained chemotherapy （P〈0.05）. There was a trend toward superior outcome for patients who received combined therapy （surgery/ chemotherapy/radiotherapy） （P=0.055）. Patients who had CR, primary tumor diameter 〈7.5 cm and IPI score ≤1 were significantly associated with longer PFS at multivariate analysis. Conclusions： Primary testicular DLBCL had poorer survival. CR, primary tumor diameter and IPI were independent prognostic factors. The combined therapy of orchectomy, doxorubicin-contained chemotherapy and contralateral testicular radiotherapy （RT） seemed to improve survival.

Primary early-stage intestinal and colonic non-Hodgkin's lymphoma: Clinical features, management, and outcome of 37 patients

AIM： To analyze the clinical features, management, and outcome of treatment of patients with primary intestinal and colonic non-Hodgkin＇s lymphoma （PICL）. METHODS： A retrospective study was performed in 37 patients with early-stage PICL who were treated in our hospital from 1958 to 1998. Their clinical features, management, and outcome were assessed. Prognostic factors for survival were analyzed by univariate analysis using the Kaplan-Meier product-limit method and log-rank test. RESULTS： Twenty-five patients presented with Ann Arbor stage Ⅰ PICL and 12 with Ann Arbor stage Ⅱ PICL. Thirty-five patients underwent surgery （including 31 with complete resection）, 22 received postoperative chemotherapy or radiotherapy or both. Two patients with rectal tumors underwent biopsy and chemotherapy with or without radiotherapy. The 5- and 10-year overall survival （OS） rates were 51.9% and 44.5%. The corresponding diseasefree survival （DIS） rates were 42.4% and 37.7%. In univariate analysis, multiple-modality treatment was associated with a better DFS rate compared to single treatment （P= 0.001）. While age, tumor size, tumor site, stage, histology, or extent of surgery were not associated with OS and DFS, use of adjuvant chemotherapy significantly improved DFS （P = 0.031） for the 31 patients who underwent complete resection. Additional radiotherapy combined with chemotherapy led to a longer survival than chemotherapy alone in six patients with gross residual disease after surgery or biopsy.CONCLUSION： Combined surgery and chemotherapy is recommended for treatment of patients with PICL, Additional radiotherapy is needed to improve the outcome of patients who have gross residual disease after surgery.

Addition of rituximab is not associated with survival benefit compared with CHOP alone for patients with stage I diffuse large B-cell lymphoma

Background： The role of rituximab in combination with CHOP regimen in patients with stage I diffuse large B-cell lymphoma （DLBCL） remains to be defined. We aimed to compare CHOP plus rituximab （R-CHOP） with CHOP alone and determine the value of radiotherapy in these patients. Methods： Between 2003 and 2009, 140 untreated patients with stage I DLBCL were retrospectively analyzed in this study. Results： Seventy-eight patients were treated in R-CHOP group and 62 in CHOP group. Ninety-one patients received additional radiotherapy at the end of chemotherapy. The different treatment groups were well-balanced with respect to baseline characteristics. Complete response （CR） rate was 77% both in R-CHOP and CHOP groups （P=0.945）. After a median follow-up period of 56 months, patients received R-CHOP regimen had similar 5-year progression-free survival （PFS） （76% vs. 85%; log-rank P=0.215） and 5-year overall survival （OS） （90% vs. 96%; log-rank P=0.175） compared with those with CHOP alone. Patients with radiotherapy had significantly increased 5-year PFS compared with those who had chemotherapy alone （86% vs. 71%; log-rank P=0.005）. At multivariate analysis, patients who had CR （P=0.008） and received radiotherapy （P=0.003） were significantly associated with superior PFS. Conclusions： CHOP alone could be as effective as R-CHOP regimen and additional radiotherapy would be necessary for stage I or stage I non-bulky DLBCL patients.

Forty-six cases of nasopharyngeal carcinoma treated with 50 Gy radiotherapy plus hematoporphyrin derivative:20 years of follow-up and outcomes from the Sun Yat-sen University Cancer Center

Background:With the improved overall survival(OS) of nasopharyngeal carcinoma(NPC) patients,the importance of quality of life(Qo L) is increasingly being recognized.For some radiosensitive NPC patients,whether low?dose radio?therapy can improve the Qo L without affecting clinical efficacy is unknown.This study aimed to assess the survival rates and Qo L of NPC patients treated with 50 Gy radiotherapy plus hematoporphyrin derivative(HPD).Methods:Forty?six newly diagnosed NPC patients treated with 50 Gy radiotherapy plus HPD between June 1988 and July 1992 were analyzed.All patients were restaged according to the 7th edition of the American Joint Commit?tee on Cancer staging system.The radiotherapy plan was designed on the basis of pretreatment computed tomog?raphy.The OS,local recurrence?free survival(LRFS),distant metastasis?free survival(DMFS),and disease?free survival(DFS) rates were estimated using the Kaplan–Meier method.Qo L was assessed using the Late Radiation Morbidity Scoring Criteria of the Radiation Therapy Oncology Group.Results:The 5?year OS,LRFS,DMFS,and DFS rates were 74.3%,72.6%,82.1%,and 61.2%,respectively.The corre?sponding 10?year rates were 38.4%,62.9%,78.5%,and 49.8%,respectively,and the 20?year rates were 27.7%,51.4%,78.5%,and 40.7%,respectively.None of the patients developed severe radiation?related complications,such as radiation?induced temporal lobe necrosis,hearing loss,trismus,and dysphagia.Conclusion:Some NPC patients were sensitive to 50 Gy radiotherapy plus HPD,and this sensitivity was characterized by long?term survival without significant late treatment morbidities.

Clinical and therapeutic considerations of rectal lymphoma: A case report and literature review

Primary rectal lymphoma is a rare presentation of gastrointestinal lymphomas. Its clinical presentation is indistinguishable from that of rectal carcinoma. Although surgical resection is often technically feasible, optimal therapy for colorectal lymphoma has not yet been identified.We report a case of primary rectal lymphoma (nonHodgkin's large cell lymphoma of type B) with high-grade features that disappeared completely after chemoradiotherapy. This case underlines that primary treatment with systemic chemotherapy and involved-field radiotherapy can be successful for rectal lymphoma, with surgery reserved for complications and chemotherapy failures.

Outcomes of patients treated with SVILE vs.P-GemOx for extranodal natural killer/T-cell lymphoma,nasal type:a prospective,randomized controlled study

Objective:To compare the efficacy and safety of the novel SVILE regimen with the P-GemOx regimen in patients with newly diagnosed extranodal natural killer/T-cell lymphoma,nasal type(ND-ENKTL).Methods:From April 2015 to July 2018,103 patients with ND-ENKTL were randomly assigned to SVILE(experimental group)or P-GemOx(control group)chemotherapy followed by radiotherapy and consolidation chemotherapy.The primary endpoint was the overall response rate after 3 cycles of chemotherapy,and secondary study endpoints were complete response(CR),progression-free survival(PFS),and overall survival(OS).Safety was also evaluated.Results:There were no significant differences in baseline characteristics in the experimentalvs.control groups.In experimental and control groups,respectively,the overall response rates were 91.7%vs.97.0%for stageI/II and 75.0%vs.72.2%for stage III/IV.The CR rates were 83.4%vs.97.0%for stage I/II and 68.8%vs.61.1%for stage III/IV.None of those differences were significant.There was no significant difference in PFS and OS between groups and between patients in stage I/II and stage III/IV.The 3-year PFS and OS in stage I/II were 88.3%vs.93.3%and 88.8%vs.97.0%,respectively.The 3-year PFS and OS in stage III/IV were 46.2%vs.65.7%and 68.8%vs.72.2%,respectively.The common adverse events were hematological toxicity,hepatotoxicity,and coagulation abnormalities,which were found to be reversible with supportive therapy.Conclusions:The novel SVILE regimen has comparable effects to those of P-GemOx in patients with ND-ENKTL and is well tolerated.SVILE is a therapeutic option for ND-ENKTL.