Localized Grade-2 Non-Hodgkins Lymphoma - Results Of Treatment With Radiotherapy

This report reviews 85 patients entered into the British National Lymphoma Investigation with localised (clinical Stage 1 and 2) Grade 2 non-Hodgkin's lymphoma, who were treated initially with radiotherapy alone. Almost half of all patients presented with extranodal disease. The duration of follow-up was 20-106 months. There were 33 deaths due to non-Hodgkin's lymphoma. The complete local response rate was dependent on the radiotherapy dose and reached 100% for doses of 4500 cGy or more. Most first failures occurred at a distant nodal site or were due to the development of generalised disease. There was a significant difference in actuarial survival between Stage 1 and Stage 2 patients (P less than 0.005). The 5-year survivals were 78% and 40%, respectively. The site of presenting disease was also important. Stage 1 patients with nodal or ear, nose and throat (ENT) disease had an excellent 5-year survival of 84%, but Stage 2 patients with nodal or ENT disease had a 5-year survival of only 46%. As many of these Stage 2 patients rapidly developed disseminated disease, their survival might have been improved by treatment with chemotherapy before radiotherapy.