Stage IE primary non-Hodgkin's lymphoma of bone

The results of treatment of 28 patients with Stage IE primary lymphoma of bone were evaluated. Nine patients were treated with curative intent with irradiation alone and 19 patients received radiotherapy combined with adjuvant chemotherapy. Local control was 100%. The 10-year freedom-from-relapse rate was 53%; all relapses were distant metastases, and the median time to failure was 1 year. All patients with relapses succumbed to their disease. The 10-year cause-specific survival rate was 48%. The 10-year survival rate was 53%. Multivariate analysis of survival suggested that pathologic fracture before treatment, age greater than 60 years, no aggressive chemotherapy, and lesions that were not in long bones may influence these end points. Two patients (7%) sustained moderate or severe late toxicity. Although the likelihood of local control after treatment of Stage IE primary lymphoma of bone is very high with radiotherapy, more effective systemic regimens are needed. A significant proportion of patients with this disease die of distant metastases, despite the use of what are considered standard doxorubicin-based chemotherapy regimens.