Is comprehensive lymphatic irradiation for low-grade non-Hodgkin's lymphoma curative therapy? Long-term experience at a single institution

Purpose: This study reports 21 patients with Stage I-III low-grade non- Hodgkin's lymphoma who were treated with comprehensive lymphatic irradiation (CLI) at the University of Florida between 1966 and 1992. Methods and Materials: Sites clinically involved with disease were treated with 30 Gy, whereas clinically uninvolved sites were treated with 25 Gy. Median follow- up for the group was 14 years (24.5 years for Stage III patients). Results: Overall absolute survival rates at 5, 10, and 15 years were 84%, 68%, and 34%. Cause-specific survival rates at 5, 10, and 15 years were 84%, 68%, and 56%. Freedom-from-relapse rates at 5, 10, and 15 years were 75%, 58%, and 58%, with no relapses noted after 10 years. Bulky disease (>6 cm) was a significant indicator of poor prognosis for cause-specific survival (p = .01). Conclusion: These data support findings from other institutions suggesting a role for CLI as potentially curative therapy with acceptable toxicity and a short treatment time for patients with Stages I and II and limited Stage III disease.