Radioterapie u folikulárního lymfomu.
Stará historie v nové perspektivě?
Authors:
A. Janíková 1; J. Gombošová 2; I. Čoupková 2; J. Michalka 1; I. Vášová 1; J. Mayer 1
Authors‘ workplace:
Interní hematoonkologická klinika Lékařské fakulty Masarykovy Univerzity, Fakultní nemocnice Brno
1; Klinika radiační onkologie Lékařské fakulty Masarykovy univerzity, Masarykův onkologický ústav Brno
2
Published in:
Transfuze Hematol. dnes,16, 2010, No. 4, p. 210-217.
Category:
Comprehensive Reports, Original Papers, Case Reports
Overview
Follicular lymphoma (FL) is the most common type of low grade malignant B-cell non-Hodgkin’s lymphoma. Despite of low proliferation, FL belongs to the extremely radiosensitive tumors. The high radiosensitivity is evident from rapid onset of efficacy early during first doses of irradiation and from good global results of low dose total body irradiation (1-2 Gy). Involved field radiotherapy (IF RT) is a standard therapeutic procedure especially in the localized stages of disease. In the case of extended FL, now, a therapy is based on combination of rituximab with chemotherapy, and radiotherapy is used as an auxiliary method in a small proportion of patients only. The doses between 25 and 40 Gy are usually used. Recently, there is increasing amount of evidence concerning very low radiation doses (2x2 Gy) in recurrent follicular lymphoma with significant efficacy. Low dose radiotherapy probably leads to the induction of apoptosis via p53 pathway. This hypothesis is in accordance with a theory of FL being a disease resistant to the apoptosis. IF radiotherapy 2x2 Gy offers an extremely attractive treatment possibility with minimal toxicity that is applicable also in heavily pretreated patients and that, moreover, could be administered with success repeatedly.
Key words:
follicular lymphoma, low dose radiotherapy, rituximab, microenvironment
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