Published online Sep 28, 2013. doi: 10.3748/wjg.v19.i36.6062
Revised: July 8, 2013
Accepted: July 18, 2013
Published online: September 28, 2013
AIM: To evaluate the clinical outcomes of radiation therapy (RT) for early-stage gastric mucosa-associated lymphoid tissue lymphoma (MALToma).
METHODS: The records of 64 patients treated between 1998 and 2011 were analyzed retrospectively. For Helicobacter pylori (H. pylori)-positive patients (n = 31), chemotherapy or H. pylori eradication therapy was the initial treatment. In patients with failure after H. pylori eradication, RT was performed. For H. pylori-negative patients (n = 33), chemotherapy or RT was the first-line treatment. The median RT dose was 36 Gy. The target volume included the entire stomach and the perigastric lymph node area.
RESULTS: All of the patients completed RT without interruption and showed complete remission on endoscopic biopsy after treatment. Over a median follow-up period of 39 mo, the 5-year local control rate was 89%. Salvage therapy was successful in all relapsed patients. Secondary malignancies developed in three patients. The 5-year overall survival rate was 94%. No patient presented symptoms of moderate-to-severe treatment-related toxicities during or after RT.
CONCLUSION: Radiotherapy results in favorable clinical outcomes in patients with early-stage gastric MALToma who experience failure of H. pylori eradication therapy and those who are H. pylori negative.
Core tip: Radiation therapy is an effective salvage treatment for patients with gastric mucosa-associated lymphoid tissue lymphoma (MALToma) who experience failure of Helicobacter pylori (H. pylori) eradication therapy. For patients with H. pylori-negative gastric MALToma, radiation therapy is recommended as the initial treatment. The risk of treatment-related toxicities and secondary malignancies is acceptable.