Treatment outcome of mucosa-associated lymphoid tissue/marginal zone non-Hodgkin's lymphoma

PURPOSE: To evaluate the treatment outcome in patients with mucosa-associated lymphoid tissue (MALT)/marginal zone (MZ) non-Hodgkin's lymphoma (NHL). MATERIALS AND METHODS: Between 1986 and 2000, 66 patients with clinical stage (CS) I-IV MALT/MZ NHL were treated; these comprise the study population. The progression-free survival (PFS) and overall survival (OS) were calculated using the Kaplan-Meier technique. Forty-five patients (68%) had CS I-II and 21 (32%) had CS III-IV disease. Twenty-nine of the 45 CS I-II patients received radiation therapy (RT) alone, and 6 patients had surgery and RT. The median RT dose was 3350 cGy. Among the 21 CS III-IV patients, treatment included chemotherapy alone (15), chemotherapy + RT (3), surgery (1), surgery + chemotherapy (1), and RT alone (1). Median follow-up was 48 months. RESULTS: All 35 early-stage and all 4 advanced-stage patients who received RT as part of initial treatment achieved local control. Among the 63 evaluable patients, the 5-year OS and PFS were 90 and 57%, respectively. The 5-year OS was 93% and PFS was 75% among CS I-II patients; the corresponding estimates in CS III-IV patients were 83% and 14%, respectively. CONCLUSION: Modest doses of RT provide excellent local control in patients with MALT/MZ NHL. The poor PFS in advanced-stage patients suggests the need to develop alternative systemic treatment strategies for this disease.