TITLE:
Clinical Outcomes of 67 Patients Treated with Chemoradiotherapy for Primary Thyroid Non-Hodgkin’s Lymphoma in Osaka Medical College
AUTHORS:
Tsuyoshi Komori, Isamu Narabayashi, Yoshifumi Narumi, Taisuke Inomata
KEYWORDS:
Thyroid Non-Hodgkin’s Lymphoma, Chemoradiotherapy
JOURNAL NAME:
Journal of Cancer Therapy,
Vol.7 No.5,
May
5,
2016
ABSTRACT: Background: The reports of clinical
outcomes of patients treated with chemoradiotherapy for primary thyroid
non-Hodgkin’s lymphoma are rare. We report our results of chemoradiotherapy for
primary thyroid non-Hodgkin’s lymphoma. Materials and Methods: The subjects were 67 patients with thyroid
non-Hodgkin’s lymphoma among 269 patients with malignant lymphoma who received
radiotherapy in our hospital during a period between May 1990 and June 2005.
The patients included 16 men and 51 women, with a mean age of 66.2 ± 10.7 years
(30 - 84 years). The disease stage was stage I in 42 patients, stage II in 24,
and unclear in 1. The histologic type was B-cell lymphoma in 66 patients, MALT
in 9, diffuse type in 52, follicular type in 5, and diffuse and follicular type
in 1. CHOP chemotherapy regimen for malignant lymphoma patients was as follows.
Intravenous drip infusion of cyclophosphamide 750 mg/m2, (drip)
infusion of doxorubicin 50 mg/m2, and intravenous injection of
vincristine 1.4 mg/m2 were administered on day 1, followed by 5
consecutive days of oral prednisolone 100 mg/m2. This regimen was
repeated every 3 weeks (21 days) in 6 to 8 courses. Modified CHOP chemotherapy
regimen was as follows. Intravenous drip
infusion of cyclophosphamide 600 mg/m2, intravenous (drip) infusion
of doxorubicin 40 mg/m2, intravenous infusion of vindesine 3
mg/m2, and intravenous drip infusion of prednisolone 60 mg/body were
administered on day 1, and intravenous prednisolone was changed to oral prednisolone
with the dose tapered gradually. After completing one course of this regimen,
two courses of radiotherapy (a total of 36 Gy) were performed, followed by 6
courses of the chemotherapy regimen at lower doses (80% of the initial doses)
repeated once a month. Results: Results of chemoradiotherapy in all patients were excellent. The 15-year
survival rate was over 80%. Although there were no significant differences in
the results of chemoradiotherapy among different histologic types of thyroid
malignant lymphoma, the survival rate was 100% for MALT type, as compared with
poor results for diffuse large type or diffuse mixed type. The analysis of the
results of chemoradiotherapy according to the stage of malignant thyroid
lymphomas revealed that therapeutic results were significantly better in stage
I than in stage II. Conclusion: The CHOP chemoradiotherapy regimen and modified CHOP chemoradiotherapy
regimen were excellent for primary thyroid non-Hodgkin’s lymphoma.