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Advances in clinical treatment of MALT lymphoma
Liu Ke,Zhu Suyu
Lymphoma and Abdominal Radiotherapy Department/Biological targeting Intensity Modulated Radiation Laboratory,Hunan Cancer Hospital,the Affiliated Cancer Hospital of Xiangya School of Medicine,Central South University,Changsha 410013,China
Abstract Mucosa-associated lymphoid tissue (MALT) lymphoma often occurs in the stomach as well as the head and neck. This disease has characteristics of multi-site dissemination and indolent development,and about 80% of MALT lymphoma patients are in early stage. Helicobacter pylori (Hp) eradication is the main method for treating early-stage Hp-positive gastric MALT lymphoma. For patients with other types of early-stage MALT lymphoma and those with gastric MALT lymphoma who failed Hp eradication therapy,radiotherapy has a good clinical effect. In recent years,radiotherapy target volume has changed from the involved field to the involved site,and the dose has been decreased. This article provides a review of the above aspects.
[1] Raderer M,Kiesewetter B,Ferreri AJM.Clinicopathologic characteristics and treatment of marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma)[J].CA Cancer J Clin,2016,66(2):153-171.DOI:10.3322/caac.21330. [2] 秦燕,石远凯.结外粘膜相关淋巴组织边缘区淋巴瘤[A]//沈志祥,朱雄增.恶性淋巴瘤[M].2版.北京:人民卫生出版社,2011:556-570. Qin Y,Shi YK.Extranodal mucosa associated lymphoid tissue marginal zone lymphoma[A]//Shen ZX,Zhu XZ.Malignant lymphadenoma[M].2 ed. Beijing:People health publishing house,2011:556-570. [3] Olszewski AJ,Castillo JJ.Comparative outcomes of oncologic therapy in gastric extranodal marginal zone (MALT) lymphoma:analysis of the SEER-Medicare database[J].Ann Oncol,2013,24(5):1352-1359.DOI:10.1093/annonc/mds644. [4] Ueda K,Terui Y,Yokoyama M,et al. Non-gastric advanced mucosa-associated lymphoid tissue (MALT) lymphoma has worse prognosis than gastric MALT lymphoma even when treated with rituximab-containing chemotherapy[J].Leuk Lymphoma,2013,54(9):1928-1933.DOI:10.3109/10428194.2012.754023. [5] Vazquez A,Khan MN,Sanghvi S,et al. Extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue of the salivary glands:a population-based study from 1994 to 2009[J].Head Neck,2015,37(1):18-22.DOI:10.1002/hed.23543. [6] Hoffmann M,Whrer S,Becherer A,et al.18Fluoro-deoxy-glucose positron emission tomography in lymphoma of mucosa-associated lymphoid tissue:histology makes the difference[J].Ann Oncol,2006,17(12):1761-1765.DOI:10.1093/annonc/mdl295. [7] Barrington SF,Mikhaeel NG,Kostakoglu L,et al. Role of imaging in the staging and response assessment of lymphoma:consensus of the international conference on malignant lymphomas imaging working group[J].J Clin Oncol,2014,32(27):3048-3058.DOI:10.1200/JCO.2013.53.5229. [8] Kiesewetter B,Lukas J,Kuchar A,et al. Clinical features,treatment and outcome of mucosa-associated lymphoid tissue (MALT) lymphoma of the ocular adnexa:single center experience of 60 patients[J/OL].PLoS One,2014,9(7):e104004.DOI:10.1371/journal.pone.0104004. [9] NCCN clinical practice guidelines in oncology (NCCN Guidelines).Non-Hodgkin’s lymphomas,Version 3.2016[DB/OL][2017-01-02].http://guide.medlive.cn/guideline/preview/1/10966?token=33877bb215a39 de8ca1 d87 d3 d7 d2919c?. [10] 常树建,石鑫,徐振宇,等.TNM分期与Lugano分期在预测原发性胃肠道恶性淋巴瘤患者生存中的作用比较[J].中国肿瘤临床,2015,42(7):392-396.DOI:10.3969/j.issn.1000-8179.20150081. Chang SJ,Shi X,Xu XY,et al. Comparison of TNM and Lugano staging systems in predicting 5-year survival rate of primary gastrointestinal lymphoma patients[J].Chin J Clin Oncol,2015,42(7):392-396.DOI:10.3969/j.issn.1000-8179.20150081. [11] Wotherspoon AC,Ortiz-Hidalgo C,Falzon MR,et al. Helicobacter pylori-associated gastritis and primary B-cell gastric lymphoma[J].Lancet,1991,338(8776):1175-1176.DOI:10.1016/0140-6736(91)92035-Z. [12] Stathis A,Chini C,Bertoni F,et al. Long-term outcome following Helicobacter pylori eradication in a retrospective study of 105 patients with localized gastric marginal zone B-cell lymphoma of MALT type[J].Ann Oncol,2009,20(6):1086-1093.DOI:10.1093/annonc/mdn760. [13] Chen LT,Lin JT,Tai JJ,et al. Long-term results of anti-Helicobacter pylori therapy in early-stage gastric high-grade transformed MALT lymphoma[J].J Natl Cancer Inst,2005,97(18):1345-1353.DOI:10.1093/jnci/dji277. [14] Zucca E,Copie-Bergman C,Ricardi U,et al. Gastric marginal zone lymphoma of MALT type:ESMO clinical practice guidelines for diagnosis,treatment and follow-up[J].Ann Oncol,2013,24 Suppl 6:vi144-vi148.DOI:10.1093/annonc/mdt343. [15] Ruskoné-Fourmestraux A,Fischbach W,Aleman BMP,et al. EGILS consensus report. Gastric extranodal marginal zone B-cell lymphoma of MALT[J].Gut,2011,60(6):747-758.DOI:10.1136/gut.2010.224949. [16] Fischbach LA,van Zanten SV,Dickason J.Meta-analysis:the efficacy,adverse events,and adherence related to first-line anti-Helicobacter pylori quadruple therapies[J].Aliment Pharmacol Ther,2004,20(10):1071-1082.DOI:10.1111/j.1365-2036.2004.02248.x. [17] Tsang RW,Gospodarowicz MK,Pintilie M,et al. Localized mucosa-associated lymphoid tissue lymphoma treated with radiation therapy has excellent clinical outcome[J].J Clin Oncol,2003,21(22):4157-4164.DOI:10.1200/JCO.2003.06.085. [18] Goda JS,Gospodarowicz M,Pintilie M,et al. Long-term outcome in localized extranodal mucosa-associated lymphoid tissue lymphomas treated with radiotherapy[J].Cancer,2010,116(16):3815-3824.DOI:10.1002/cncr.25226. [19] Nam TK,Ahn JS,Choi YD,et al. The role of radiotherapy in the treatment of gastric mucosa-associated lymphoid tissue lymphoma[J].Cancer Res Treat,2014,46(1):33-40.DOI:10.4143/crt.2014.46.1.33. [20] Nakamura S,Matsumoto T,Suekane H,et al. Long-term clinical outcome of Helicobacter pylori eradication for gastric mucosa-associated lymphoid tissue lymphoma with a reference to second-line treatment[J].Cancer,2005,104(3):532-540.DOI:10.1002/cncr.21152. [21] Vrieling C,de Jong D,Boot H,et al. Long-term results of stomach-conserving therapy in gastric MALT lymphoma[J].Radiother Oncol,2008,87(3):405-411.DOI:10.1016/j.radonc.2008.02.012. [22] Abe S,Oda I,Inaba K,et al. A retrospective study of 5-year outcomes of radiotherapy for gastric mucosa-associated lymphoid tissue lymphoma refractory to Helicobacter pylori eradication therapy[J].Jpn J Clin Oncol,2013,43(9):917-922.DOI:10.1093/jjco/hyt097. [23] Jger G,Neumeister P,Brezinschek R,et al. Treatment of extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue type with cladribine:a phase Ⅱ study[J].J Clin Oncol,2002,20(18):3872-3877.DOI:10.1200/JCO.2002.05.117. [24] Whrer S,Drach J,Hejna M,et al. Treatment of extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma) with mitoxantrone,chlorambucil and prednisone (MCP)[J].Ann Oncol,2003,14(12):1758-1761. [25] Martinelli G,Laszlo D,Ferreri AJM,et al. Clinical activity of rituximab in gastric marginal zone non-hodgkin’s lymphoma resistant to or not eligible for anti–Helicobacter pylori therapy[J].J Clin Oncol,2005,23(9):1979-1983.DOI:10.1200/JCO.2005.08.128. [26] Raderer M,Wohrer S,Streubel B,et al. Activity of rituximab plus cyclophosphamide,doxorubicin/mitoxantrone,vincristine and prednisone in patients with relapsed MALT lymphoma[J].Oncology,2006,70(6):411-417.DOI:10.1159/000098555. [27] Salar A,Domingo-Domenech E,Estany C,et al. Combination therapy with rituximab and intravenous or oral fludarabine in the first-line,systemic treatment of patients with extranodal marginal zone b-cell lymphoma of the mucosa-associated lymphoid tissue type[J].Cancer,2009,115(22):5210-5217.DOI:10.1002/cncr.24605. [28] Conconi A,Martinelli G,Lopez-Guillermo A,et al. Clinical activity of bortezomib in relapsed/refractory malt lymphomas:results of a phase ii study of the international extranodal lymphoma study group (IELSG)[J].Ann Oncol,2011,22(3):689-695.DOI:10.1093/annonc/mdq416. [29] Zucca E,Conconi A,Laszlo D,et al. Addition of rituximab to chlorambucil produces superior event-free survival in the treatment of patients with extranodal marginal-zone b-cell lymphoma:5-year analysis of the IELSG-19 randomized study[J].J Clin Oncol,2013,31(5):565-572.DOI:10.1200/JCO.2011.40.6272. [30] Olszewski AJ,Desai A.Radiation therapy administration and survival in stage Ⅰ/Ⅱ extranodal marginal zone B-Cell lymphoma of mucosa-associated lymphoid tissue[J].Int J Radiat Oncol Biol Phys,2014,88(3):642-649.DOI:10.1016/j.ijrobp.2013.11.225. [31] 李晔雄.胃肠道淋巴瘤放疗进展[J].中华结直肠疾病电子杂志,2016,5(2):114-120.DOI:10.3877/cma.j.issn.2095-3224.2016.02.02. Li YX.Recent progress in radiation therapy for primary gastrointestinal lymphoma[J].Chin J Colorec Dis (Elec ed),2016,5(2):114-120.DOI:10.3877/cma.j.issn.2095-3224.2016.02.02. [32] Specht L,Yahalom J.The concept and evolution of involved site radiation therapy for lymphoma[J].Int J Clin Oncol,2015,20(5):849-854.DOI:10.1007/s10147-015-0863-y. [33] Yahalom J,Illidge T,Specht L,et al. Modern radiation therapy for extranodal lymphomas:field and dose guidelines from the international lymphoma radiation oncology group[J].Int J Radiat Oncol Biol Phys,2015,92(1):11-31.DOI:10.1016/j.ijrobp.2015.01.009. [34] Specht L,Yahalom J,Illidge T,et al. Modern radiation therapy for hodgkin lymphoma:field and dose guidelines from the international lymphoma radiation oncology group (ILROG)[J].Int J Radiat Oncol Biol Phys,2014,89(4):854-862.DOI:10.1016/j.ijrobp.2013.05.005. [35] Girinsky T,Paumier A,Ferme C,et al. Low-dose radiation treatment in pulmonary mucosa-associated lymphoid tissue lymphoma:a plausible approach? A single-institution experience in 10 patients[J].Int J Radiat Oncol Biol Phys,2012,83(3):e385-e389.DOI:10.1016/j.ijrobp.2012.01.005. [36] Hoskin PJ,Kirkwood AA,Popova B,et al.4 Gy versus 24 Gy radiotherapy for patients with indolent lymphoma (FORT):a randomised phase 3 non-inferiority trial[J].Lancet Oncol,2014,15(4):457-463.DOI:10.1016/S1470-2045(14)70036-1. [37] Lowry L,Smith P,Qian WD,et al. Reduced dose radiotherapy for local control in non-Hodgkin lymphoma:a randomised phase Ⅲ trial[J].Radiother Oncol,2011,100(1):86-92.DOI:10.1016/j.radonc.2011.05.013. [38] Tanimoto K,Kaneko A,Suzuki S,et al. Long-term follow-up results of no initial therapy for ocular adnexal MALT lymphoma[J].Ann Oncol,2006,17(1):135-140.DOI:10.1093/annonc/mdj025.