Incidence,characteristics, management and outcome of patients with follicular lymphoma with tumor epidural compression,a study on 22 cases |
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| Affiliation: | 1. Radiation therapy department, Gustave-Roussy, 114, rue Édouard-Vaillant, 94800 Villejuif, France;2. Hematology department, Gustave-Roussy, 114, rue Édouard-Vaillant, 94800 Villejuif, France;3. Internal medicine department, hôpital Bicêtre, AP–HP, 78, rue du Général-Leclerc, 94270 Le Kremlin-Bicêtre, France;1. Laboratoire d’imagerie translationnelle en oncologie (Lito), Institut Curie, université PSL, université Paris Saclay, Inserm, 91898 Orsay, France;2. Département de radiothérapie oncologique, institut Curie, université PSL, Centre de protonthérapie, centre universitaire, 91898 Orsay, France;3. Département d’oncologie médicale, institut Curie, Paris, France;4. Département de radiothérapie oncologique, institut Curie, université PSL, Paris, France;1. Service d’oncologie-radiothérapie, institut du cancer de Montpellier, 208, avenue des Apothicaires, 34090 Montpellier, France;2. Service de statistiques, institut du cancer de Montpellier, 208, avenue des Apothicaires, 34090 Montpellier, France;1. Department of Obstetrics and Gynecology, University of Miami, Miami, FL, United States;2. Division of Gynecologic Oncology, Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL, United States;3. Department of Pathology, University of Miami, Miami, FL, United States;1. Department of Oral and Maxillofacial Oncology & Surgery, Xinjiang Medical University Affiliated First Hospital, Urumqi 830054, China;2. School/Hospital of Stomatology, Xinjiang Medical University, Urumqi 830011, China;3. Stomatological Research Institute of Xinjiang Uygur Autonomous Region, Urumqi 830054, China;4. Department of Preventive Medicine, School of Medicine, Shihezi University, Shihezi 832003, China;5. Department of Oral and Maxillofacial Surgery, Shanghai Stomatological Hospital & School of Stomatology, Fudan University, Shanghai 200003, China;6. Shanghai Key Laboratory of Craniomaxillofacial Development and Diseases, Fudan University, Shanghai 200433, China;7. State Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Diseases, Shaanxi Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China;8. The First Ward of Oncological Department, Cancer Center, the First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, China;1. Radiation Department, institut de cancérologie de Loraine Alexis-Vautrin, Academic Department of Radiation Therapy and Brachytherapy, 6, avenue de Bourgogne, CS 30519, 54511 Vandœuvre-lès-Nancy, France;2. Radiation Department, centre Émile-Durkheim, Épinal, France |
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| Abstract: | PurposeFollicular lymphoma (FL) is one of the most common lymphoma. Occasionally, FL is associated with tumoral epidural compression and management of these patients remain poorly codified. This study aims to report incidence, clinical characteristics, management and outcomes of patients with FL and tumoral epidural compression.Material and methodsObservational, retrospective cohort study of adult patients with FL and epidural tumor compression, treated in a French Institute over the last 20 years (2000–2021).ResultsBetween 2000 and 2021, 1382 patients with FL were followed by the haematological department. Of them, 22 (1.6%) patients (16 men and 6 women) had follicular lymphoma with epidural tumor compression. At epidural tumor compression occurrence, 8/22 (36%) patients had a neurological clinical deficit (motor, sensory or sphincter function) and 14/22 (64%) had tumor pain. All patients were treated with immuno-chemotherapy; the main regimen being used was R-CHOP plus high dose IV methotrexate in 16/22 (73%) patients. Radiotherapy for tumor epidural compression was performed in 19/22 (86%) patients. With a median follow-up of 60 months (range = [1–216]), 5 year local tumor relapse free survival was achieved in 65% (95% CI 47–90%) of patients. The median PFS was of 36 months (95% CI 24–NA) and 5 years OS estimate was 79% (95% CI 62–100%). Two patients developed a relapse at a second epidural site.ConclusionFL with tumoral epidural compression reached 1.6% of all FL patients. Management based on immuno-chemotherapy with radiotherapy appeared to produce comparable outcomes with the general FL population. |
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