Journal of Clinical Oncology, Vol 18, Issue 1
(January), 2000: 54
© 2000 American Society for Clinical Oncology
Angiocentric Lymphoma of the Head and Neck: Patterns of Systemic Failure After Radiation Treatment
By Gwi Eon Kim,
Jae Ho Cho,
Woo Ick Yang,
Eun Ji Chung,
Chang Ok Suh,
Kyung Ran Park,
Won Pyo Hong,
In Yong Park,
Jee Sook Hahn,
Jae Kyung Roh,
Byung Soo Kim
From the Departments of Radiation Oncology, Pathology, Internal Medicine, and Otorhinolaryngology, Yonsei University College of Medicine, Yonsei Cancer Center, Seoul, Korea.
Address reprint requests to Gwi Eon Kim, MD, Department of Radiation Oncology, Yonsei University College of Medicine, Yonsei Cancer Center, CPO Box 8044, Seoul 120-752, Korea; email therapy@ yumc.yonsei.ac.kr.
PURPOSE: To investigate the patterns of systemic failure and the clinical outcome in patients with angiocentric lymphoma of the head and neck who were treated with radiation alone, and to discuss the optimal mode of treatment for these patients.
PATIENTS AND METHODS: We reviewed the records of 92 patients with stage I or II angiocentric lymphoma who were treated at Yonsei Cancer Center between 1976 and 1994. All patients were treated with involved-field irradiation. Radiation doses ranged from 40 to 60 Gy (median dose, 50.4 Gy). Treatment response, patterns of treatment failure including systemic failure, and clinical outcome after radiation treatment were analyzed.
RESULTS: The most frequently involved site was the nasal cavity, either alone or in conjunction with other sites. In 16 patients (17.4%), angiocentric lymphoma was accompanied by cervical lymphadenopathy. Disease was classified as stage I in 62 patients (67.4%) and stage II in 30 patients (32.6%). After completion of radiation treatment, 61 patients (66.3%) achieved a complete response and 16 (17.4%) a partial response. Half of the patients (50.0%) ultimately experienced local recurrence with or without other components of failure, whereas regional failure was relatively uncommon (10.9%). Systemic failure occurred in 25.0% of patients during follow-up. Six patients had histologic findings identical to those at the time of the original disease (group I), whereas four patients exhibited morphologic features of frank lymphomas (group II). The majority of patients with systemic relapse had the predilection sites for widespread extranodal involvement, such as the skin, brain, lung, gastrointestinal tract, or testes. In addition, seven patients died from various medical illnesses or immunologic disorders, including hemophagocytic syndrome and second primary cancers (group III). After a median follow-up of 56 months, the overall survival and disease-free survival rates for all patients were 40.1% and 37.8%, respectively. All patients except one with systemic failure died within 1 year.
CONCLUSION: Treatment with radiation alone had suboptimal results, partly because of the occurrence of a variety of systemic failure with diverse clinicopathologic features. Given the frequent occurrence of systemic failure after radiation treatment, we believe that the multimodality treatment approach containing more effective chemotherapeutic agents should be incorporated in the treatment of angiocentric lymphoma confined to the head and neck.
 CiteULike  Complore  Connotea  Del.icio.us  Digg  Facebook  Reddit  Technorati  Twitter What's this?
This article has been cited by other articles:
|
|
|
|
 
B.-S. Kim, D.-W. Kim, S.-A. Im, C. W. Kim, T.-Y. Kim, S.-S. Yoon, D. S. Heo, Y.-J. Bang, S. Park, B. K. Kim, et al.
Effective second-line chemotherapy for extranodal NK/T-cell lymphoma consisting of etoposide, ifosfamide, methotrexate, and prednisolone
Ann. Onc.,
January 1, 2009;
20(1):
121 - 128.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
C. Suh, Y.-K. Kang, J.-L. Roh, M. R. Kim, J. S. Kim, J. Huh, J. H. Lee, Y. J. Jang, and B.-J. Lee
Prognostic Value of Tumor 18F-FDG Uptake in Patients with Untreated Extranodal Natural Killer/T-Cell Lymphomas of the Head and Neck
J. Nucl. Med.,
November 1, 2008;
49(11):
1783 - 1789.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. Kim, B. Kim, C. Choi, J Choi, I Kim, Y-H Lee, and J. Kim
Ki-67 expression is predictive of prognosis in patients with stage I/II extranodal NK/T-cell lymphoma, nasal type
Ann. Onc.,
August 1, 2007;
18(8):
1382 - 1387.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. Lee, C. Suh, J. Huh, H. J. Jun, K. Kim, C. Jung, K. Park, Y. H. Park, Y. H. Ko, and W. S. Kim
Effect of Positive Bone Marrow EBV In situ Hybridization in Staging and Survival of Localized Extranodal Natural Killer/T-Cell Lymphoma, Nasal-Type
Clin. Cancer Res.,
June 1, 2007;
13(11):
3250 - 3254.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
C. Bossard, K. Belhadj, F. Reyes, N. Martin-Garcia, F. Berger, J. A. Kummer, J. Briere, A.-C. Baglin, S. Cheze, J. Bosq, et al.
Expression of the granzyme B inhibitor PI9 predicts outcome in nasal NK/T-cell lymphoma: results of a Western series of 48 patients treated with first-line polychemotherapy within the Groupe d'Etude des Lymphomes de l'Adulte (GELA) trials
Blood,
March 1, 2007;
109(5):
2183 - 2189.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
Y.-X. Li, B. Yao, and J. Jin
In Reply:
J. Clin. Oncol.,
June 10, 2006;
24(17):
2685 - 2686.
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. A. Rizvi, A. M. Evens, M. S. Tallman, B. P. Nelson, and S. T. Rosen
T-cell non-Hodgkin lymphoma
Blood,
February 15, 2006;
107(4):
1255 - 1264.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. Lee, C. Suh, Y. H. Park, Y. H. Ko, S. M. Bang, J. H. Lee, D. H. Lee, J. Huh, S. Y. Oh, H.-C. Kwon, et al.
Extranodal Natural Killer T-Cell Lymphoma, Nasal-Type: A Prognostic Model From a Retrospective Multicenter Study
J. Clin. Oncol.,
February 1, 2006;
24(4):
612 - 618.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
Y.-X. Li, B. Yao, J. Jin, W.-H. Wang, Y.-P. Liu, Y.-W. Song, S.-L. Wang, X.-F. Liu, L.-Q. Zhou, X.-H. He, et al.
Radiotherapy As Primary Treatment for Stage IE and IIE Nasal Natural Killer/T-Cell Lymphoma
J. Clin. Oncol.,
January 1, 2006;
24(1):
181 - 189.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
T. M. Kim, Y. H. Park, S.-Y. Lee, J.-H. Kim, D.-W. Kim, S.-A. Im, T.-Y. Kim, C. W. Kim, D. S. Heo, Y.-J. Bang, et al.
Local tumor invasiveness is more predictive of survival than International Prognostic Index in stage IE/IIE extranodal NK/T-cell lymphoma, nasal type
Blood,
December 1, 2005;
106(12):
3785 - 3790.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
K. Kim, E. K. Chie, C. W. Kim, I. H. Kim, and C. I. Park
Treatment Outcome of Angiocentric T-cell and NK/T-cell Lymphoma, Nasal Type: Radiotherapy Versus Chemoradiotherapy
Jpn. J. Clin. Oncol.,
January 1, 2005;
35(1):
1 - 5.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
C.-S. Chim, S.-Y. Ma, W.-Y. Au, C. Choy, A. K. W. Lie, R. Liang, C.-C. Yau, and Y.-L. Kwong
Primary nasal natural killer cell lymphoma: long-term treatment outcome and relationship with the International Prognostic Index
Blood,
January 1, 2004;
103(1):
216 - 221.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
W. Y. Au, A. K. W. Lie, R. Liang, Y.-L. Kwong, C.-C. Yau, M. M. C. Cheung, K.-C. Ngan, W.-H. Lau, K.-H. Wong, H.-Y. Yiu, et al.
Autologous stem cell transplantation for nasal NK/T-cell lymphoma: a progress report on its value
Ann. Onc.,
November 1, 2003;
14(11):
1673 - 1676.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M.-L. H. Fjallskog, M. H. Lejonklou, K. E. Oberg, B. K. Eriksson, and E. T. Janson
Expression of Molecular Targets for Tyrosine Kinase Receptor Antagonists in Malignant Endocrine Pancreatic Tumors
Clin. Cancer Res.,
April 1, 2003;
9(4):
1469 - 1473.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
L. Quintanilla-Martinez, M. Kremer, G. Keller, M. Nathrath, A. Gamboa-Dominguez, A. Meneses, L. Luna-Contreras, A. Cabras, H. Hoefler, A. Mohar, et al.
p53 Mutations in Nasal Natural Killer/T-Cell Lymphoma from Mexico : Association with Large Cell Morphology and Advanced Disease
Am. J. Pathol.,
December 1, 2001;
159(6):
2095 - 2105.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. P. Greer, M. C. Kinney, and T. P. Loughran Jr.
T Cell and NK Cell Lymphoproliferative Disorders
Hematology,
January 1, 2001;
2001(1):
259 - 281.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
