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Low-Dose Radiation Therapy Looks Effective in Hard-to-Treat MCL

Key clinical point: Low-dose radiation administered to multiple sites was highly effective in patients with relapsed, refractory mantle cell lymphoma, with or without concurrent chemotherapy.

Major finding: The overall survival was 90% at 1 year following the initiation of low-dose radiation therapy (4 Gy).

Study details: A study of 19 patients with relapsed, refractory mantle cell lymphoma who received low-dose radiation at doses of 4 Gy at 98 sites of disease.

Disclosures: The study was supported in part by a grant from the National Cancer Institute. The researchers reported having no competing financial interests.

Citation:

Ning MS et al. Blood Adv. 2019. Jul 9;3(13):2035-9.

Commentary:

Is low-dose radiation an effective therapy for mantle cell lymphoma? This retrospective analysis of 19 patients treated at the MD Anderson Cancer Center over several years suggests that the answer is “yes”. In some cases, patients received low-dose radiation along with systemic therapy, while a small number of patients received radiation in isolation. Patients underwent radiation to anywhere from 1 to 27 distinct sites of disease. The majority of irradiated lymph nodes decreased in size. Local recurrences were less common than out-of-field progression (which tended to occur quickly); toxicities were minimal. Mantle cell lymphoma is a systemic disease, particularly among patients with ibrutinib failure. It is uncommon that radiation would be incorporated into standard management. But all of us face the occasional challenging case of a trouble-making lymph node, so it is useful to remember that low-dose radiation can sometimes help.—Peter Martin, MD