The Korean Journal of Medicine

The Korean Association of Internal Medicine (대한내과학회)
권호 표지
DOI QR코드

DOI QR Code

The Role of Radiotherapy for the Treatment of Gastric MALT Lymphoma

위말트림프종에서 방사선 치료의 역할

  • Ahn, Jae-Sook (Department of Internal Medicine, Chonnam National University Medical School) ;
  • Nam, Taek-Keun (Department of Radiation Oncology, Chonnam National University Medical School)
  • 안재숙 (전남대학교 의과대학 내과학교실) ;
  • 남택근 (전남대학교 의과대학 방사선종양학과)
  • Published : 2012.12.01
⟨ Previous Next ⟩

Abstract

Gastric mucosa-associated lymphoid tissue (MALT) lymphoma represents approximately 9% of all malignant lymphoma in Korean, and its incidence is higher than that of western and other Asian countries. Helicobacter pylori eradication is the first line treatment in limited stage gastric MALT lymphoma. There is no consensus about initial treatment with chemotherapy or radiotherapy for the patient with insufficient response to H. pylori eradication or H. pylori negative. Radiotherapy is a conventional therapeutic modality and showed the excellent long term results. The radiotherapy for limited gastric MALT lymphoma shows that the 4-5-year disease free survival rate is 85-100% and acute toxicities is reasonable. However, only non-randomized studies support a role of local radiotherapy in gastric MALT lymphoma.

Keywords

References

  1. Park HJ, Park EH, Jung KW, et al. Statistics of hematologic malignancies in Korea: incidence, prevalence and survival rates from 1999 to 2008. Korean J Hematol 2012;47:28-38. https://doi.org/10.5045/kjh.2012.47.1.28
  2. Fauci AS, Harrison TRPoim. Harrison's Principles of Internal Medicine. 17th ed. New York; London: McGraw-Hill Medical, 2008.
  3. Kim JM, Ko YH, Lee SS, et al. WHO classification of malignant lymphomas in Korea: report of the third nation-wide study. Korean J Pathol 2011;45:254-260. https://doi.org/10.4132/KoreanJPathol.2011.45.3.254
  4. Hahn JS, Kim YS, Lee YC, Yang WI, Lee SY, Suh CO. Eleven-year experience of low grade lymphoma in Korea (based on REAL classification). Yonsei Med J 2003;44:757-770. https://doi.org/10.3349/ymj.2003.44.5.757
  5. Wotherspoon AC. Gastric MALT lymphoma and Helicobacter pylori. Yale J Biol Med 1996;69:61-68.
  6. Nakamura S, Sugiyama T, Matsumoto T, et al. Long-term clinical outcome of gastric MALT lymphoma after eradication of Helicobacter pylori: a multicentre cohort follow-up study of 420 patients in Japan. Gut 2012;61:507-513. https://doi.org/10.1136/gutjnl-2011-300495
  7. Zullo A, Hassan C, Cristofari F, et al. Effects of Helicobacter pylori eradication on early stage gastric mucosa-associated lymphoid tissue lymphoma. Clin Gastroenterol Hepatol 2010;8:105-110. https://doi.org/10.1016/j.cgh.2009.07.017
  8. National Comprehensive Cancer Network. NCCN clinical practice guidelines on oncology: Non-Hodgkin's Lymphomas, verson 3.2012 [Internet]. National Comprehensive Cancer Network, c2012 [cited 2012 Oct 20]. Available from: http://www.nccn.org/professionals/physician_gls/pdf/nhl.pdf.
  9. Rohatiner A, d'Amore F, Coiffier B, et al. Report on a workshop convened to discuss the pathological and staging classifications of gastrointestinal tract lymphoma. Ann Oncol 1994;5:397-400. https://doi.org/10.1093/oxfordjournals.annonc.a058869
  10. Koch P, del Valle F, Berdel WE, et al. Primary gastrointestinal non-Hodgkin's lymphoma: II. combined surgical and conservative or conservative management only in localized gastric lymphoma: results of the prospective German Multicenter Study GIT NHL 01/92. J Clin Oncol 2001;19:3874-3883. https://doi.org/10.1200/JCO.2001.19.18.3874
  11. Park W, Chang SK, Yang WI, et al. Rationale for radiotherapy as a treatment modality in gastric mucosa-associated lymphoid tissue lymphoma. Int J Radiat Oncol Biol Phys 2004;58:1480-1486. https://doi.org/10.1016/j.ijrobp.2003.09.002
  12. Tsang RW, Gospodarowicz MK. Low-grade non-hodgkin lymphomas. Semin Radiat Oncol 2007;17:198-205. https://doi.org/10.1016/j.semradonc.2007.02.006
  13. Aleman BM, Haas RL, van der Maazen RW. Role of radiotherapy in the treatment of lymphomas of the gastrointestinal tract. Best Pract Res Clin Gastroenterol 2010;24:27-34. https://doi.org/10.1016/j.bpg.2009.12.002
  14. Vrieling C, de Jong D, Boot H, de Boer JP, Wegman F, Aleman BM. Long-term results of stomach-conserving therapy in gastric MALT lymphoma. Radiother Oncol 2008;87:405-411. https://doi.org/10.1016/j.radonc.2008.02.012
  15. Martinelli G, Laszlo D, Ferreri AJ, et al. Clinical activity of rituximab in gastric marginal zone non-Hodgkin's lymphoma resistant to or not eligible for anti-Helicobacter pylori therapy. J Clin Oncol 2005;23:1979-1983. https://doi.org/10.1200/JCO.2005.08.128
  16. Aviles A, Nambo MJ, Neri N, Talavera A, Cleto S. Mucosa-associated lymphoid tissue (MALT) lymphoma of the stomach: results of a controlled clinical trial. Med Oncol 2005;22:57-62. https://doi.org/10.1385/MO:22:1:057
  17. Mittal B, Wasserman TH, Griffith RC. Non-Hodgkin's lymphoma of the stomach. Am J Gastroenterol 1983;78:780-787.
  18. Falk S. Lymphomas of the upper GI tract: the role of radiotherapy. Clin Oncol (R Coll Radiol) 2012;24:352-357. https://doi.org/10.1016/j.clon.2012.02.003
  19. Hirose F. Induction of gastric adenocarcinoma in mice by localized x-irradiation. Gann 1969;60:253-260.
  20. Hamaloglu E, Topaloglu S, Ozdemir A, Ozenc A. Synchronous and metachronous occurrence of gastric adenocarcinoma and gastric lymphoma: a review of the literature. World J Gastroenterol 2006;12:3564-3574. https://doi.org/10.3748/wjg.v12.i22.3564
  21. Goda JS, Gospodarowicz M, Pintilie M, et al. Long-term outcome in localized extranodal mucosa-associated lymphoid tissue lymphomas treated with radiotherapy. Cancer 2010;116:3815-3824. https://doi.org/10.1002/cncr.25226
  22. Maor MH, North LB, Cabanillas FF, Ames AL, Hess MA, Cox JD. Outcomes of high-dose unilateral kidney irradiation in patients with gastric lymphoma. Int J Radiat Oncol Biol Phys 1998;41:647-650. https://doi.org/10.1016/S0360-3016(98)00083-2
  23. Tsang RW, Gospodarowicz MK, Pintilie M, et al. Localized mucosa-associated lymphoid tissue lymphoma treated with radiation therapy has excellent clinical outcome. J Clin Oncol 2003;21:4157-4164. https://doi.org/10.1200/JCO.2003.06.085

Cited by

  1. Diagnosis and Treatment of Gastric Mucosa-associated Lymphoid Tissue Lymphoma vol.74, pp.6, 2019, https://doi.org/10.4166/kjg.2019.74.6.304