Would you offer RT to a patient with a stage I low grade follicular lymphoma in the groin/upper thigh (7 cm) s/p complete excision with negative margins?

Would your recommendations change if the mass were significantly smaller, say 1-2 cm, and was completely excised with negative margins?

1 Answer

Mednet Member

Radiation Oncology · Sutter Health

Answered on

An abstract presented at the 2017 ASTRO from MD Anderson Cancer Center by Andraos and colleagues (last author Dabaja) addressed this question in a retrospective analysis. Of the 39 patients who underwent complete resection of their nodal low grade FL, "those treated with adjuvant therapy experienced significantly better LC (100% vs. 76.2% at 4 years; P = .001) and PFS (87.3% vs. 66.7% at 4 years; P = .01), with a trend toward improved OS (100% vs. 83.3% at 4 years; P = .06) Additionally, a SEER data base analysis by TJ Pugh and colleagues demonstrated that upfront radiation therapy was associated with improved clinical outcomes in patients with early stage low grade FL.

Thus, in this case, I would favor consolidation radiation therapy. I may withhold treatment if patient was young and desired fertility preservation or has developed lymphedema as the result of groin surgery.