The role of radiation therapy in adult T-cell leukemia

Five patients with adult T-cell leukemia (ATL) were treated by irradiation. Of the five patients, four were irradiated only locally to enlarged lymph nodes or cutaneous lesions as a palliative therapy. The other patient was given a single dose of 10 Gy to the total body as a definitive treatment, followed by autologous bone marrow transplantation. All five patients were treated by combined chemotherapy before irradiation. Complete reduction of lymph node enlargement and cutaneous lesions was achieved with a dose of 20 to 30 Gy. Four patients died within three months after radiotherapy, but there was no recurrence in the radiation field while new lesions developed. One patient in whom cutaneous lesions developed again after nine months of remission was alive at 10 months after irradiation. These patients responded poorly to chemotherapy. Local lesions produced by ATL were sensitive to irradiation and could be controlled by moderate irradiation doses without severe side effects. Radiotherapy did not prolong survivals, but it should be considered as a palliative method in multimodal treatment for ATL. (author)