Research in Context

Research in Context is a structured summary that editors at The Lancet’s journals ask all authors to provide when submitting an original research article. Read more

A collaboration with

Trial finds 4 Gy not non-inferior to 24 Gy for lymphoma local control

With long-term follow-up, the authors report 4 Gy was not non-inferior to 24 Gy for local control of follicular lymphoma, though 4 Gy may offer pragmatic value for palliative symptom control.

  • Peter Hoskin, MD; Biliana Popova, MSc; Oliver Schofield, MA; Caroline Brammer, FRCR; Martin Robinson, MD; A Murray Brunt, FRCR; et al.

  • February 1, 2021

  • The Lancet Oncology
  • The Lancet Oncology, Volume 22, Issue 3, Pages 332–340
  • 10.1016/S1470-2045(20)30686-0

Share

Evidence before this study

No formal systematic review has addressed radiation dose for follicular lymphoma. At the time of developing the protocol in 2004, we did a formal literature search using MEDLINE and the terms “follicular lymphoma”, “lymphoma”, “indolent lymphoma”, “low grade lymphoma”, and “radiotherapy”. We also hand-searched abstracts from meeting proceedings of European Society for Radiotherapy and Oncology (ESTRO), American Society for Radiation Oncology (ASTRO), and the Lugano International Lymphoma Meetings. These searches were updated at the time of this analysis (April 9, 2020). Our search identified several small phase 2 studies showing efficacy for 4 Gy, but no comparative trials using standard doses as control. No relevant randomised trials were found in the Cochrane Central Register of Controlled Trials.

Added value of this study

The results of this trial confirm that, with long-term follow-up, 4 Gy in two fractions is not non-inferior to 24 Gy in 12 fractions for local control when treating follicular lymphoma, in both the radical and palliative setting. Exploratory analyses show the same effect for marginal zone lymphoma and orbital lymphoma.

Implications of all the available evidence

In the palliative setting, 4 Gy of radiotherapy might provide a pragmatic treatment for local symptom control, but, for durable local control of follicular and marginal zone lymphoma, 24 Gy should be used.

Source: The Lancet Oncology

Your research deserves a global audience

The Lancet Group reaches millions of clinicians and researchers worldwide.

Publish with The Lancet Group

Related Content

Loncastuximab tesirine plus rituximab explored in relapsed or refractory follicular lymphoma.

In a single-arm, phase 2 study without a comparator arm, investigators reported high response rates in 39 patients, including high-risk subgroups; read the Research in Context.

  • by Juan Pablo Alderuccio, MD; Alvaro J Alencar, MD; Jonathan H Schatz, MD; Russ A Kuker, MD; Georgios Pongas, MD; Isildinha M Reis, PhD; et al.

  • December 7, 2024

Histology image of stained lymphatic tissue.
Phase 2 study reports responses with tazemetostat in relapsed or refractory follicular lymphoma

In heavily pretreated patients, investigators reported durable responses and a favourable safety profile with tazemetostat, and called for future studies of combination use.

  • by Franck Morschhauser, MD; Hervé Tilly, MD; Aristeidis Chaidos, MD; Pamela McKay, MD; Tycel Phillips, MD; Sarit Assouline, MD; et al.

  • October 6, 2021

Microscopic image of densely packed lymphoma cells.