Very low-dose radiotherapy for extranodal marginal zone lymphoma of bronchus-associated lymphoid tissue

Abstract

Extranodal marginal zone lymphoma of bronchus-associated lymphoid tissue (BALT) is a rare cancer for which optimal treatment strategies are undefined. Retrospective analyses suggest excellent outcomes with surgical resection for localized BALT lymphoma; however, the role of radiotherapy remains underexplored. We report the largest-to-date single-center analysis of 13 primary BALT lymphoma patients treated with radiotherapy. Of 15 treated lesions, we report a 100% response rate with complete response (CR) achieved in 67% of lesions. Among 10 lesions treated with very low-dose radiotherapy (VLDRT; 4 Gray [Gy]), 6 (60%) achieved a CR; among 5 lesions treated with full-dose radiotherapy (24–36 Gy), 4 (80%) achieved a CR. There were no local recurrences. Only one patient, treated with 30 Gy, developed an acute grade 3/4 toxic effect. There were no events of radiation-induced secondary malignancies. Our institutional experience indicates that radiotherapy, including VLDRT, is a safe and effective treatment for primary BALT lymphoma.

Keywords:

• Extranodal marginal zone lymphoma
• BALT lymphoma
• pulmonary MALT
• radiation
• very low-dose radiotherapy

Acknowledgments

The authors gratefully acknowledge MSK’s DataLine team and Jisun Lee for help querying the medical record.

Disclosure statement

The authors report there are no competing interests to declare.

Additional information

Funding

This work was supported by the National Cancer Institute [grant P30CA008748, all authors]; the Leukemia and Lymphoma Society [grant 6654-23, J.Y. and B.I.]; Gerstner Philanthropies (Louis V. Gerstner, Jr. Physician Scholars Award, M.F.); and the American Society for Radiation Oncology (Residents/Fellows in Radiation Oncology Biology Seed Grant, M.F.).