The role of radiotherapy in localized non-Hodgkin's lymphomas

Between 1970 and 1982, ninety-one patients with stages I and II non-Hodgkin's lymphomas (NHLs) submitted to radiotherapy were reviewed. After presenting data regarding histology and clinical presentation and distribution by age and sex, the authors retrospectively analysed the results according to different factors. Although 60Co teletherapy was the primary treatment for the majority of these cases, chemotherapy was also given to 65% of the patients. The conclusions are the following: (1) From a total of 261 patients with non-Hodgkin's lymphomas, 91 cases were clinical stages I and II. (2) 61.2% of the patients had extra nodal lesions, mostly of the head and neck. (3) Mediastinal involvement was present in 3.8%. However, mediastinal invasion had a higher incidence (31.7%) in children. (4) In the early stages of NHL unfavourable histological types showed a higher incidence (71.7%) than favourable ones. (5) Radiotherapy played the major role in the treatment of stages I and II, although a combination with chemotherapy was applied in 65% of the cases. There was no significant difference in survival rates between the groups (p<0.05). (6) Adults showed better disease free survival rates than did children (60 versus 40%). (7) The best results were observed in the group of patients with extralymphatic involvement of the head and neck (76.5%). (8) Response to therapy depends mainly on the histological aspects. Therefore, the 2-year relapse free survival rates are 75 and 58.9% for low and high grade malignancies, respectively. (9) Our results are in agreement with the current literature and demonstrate how NHL prognosis is connected with various factors. (author)