Retrospective analysis of stage I and II indolent lymphomas at the National Cancer Institute

We have retrospectively reviewed the records of 54 patients with Stages I and II indolent lymphoma treated at the National Cancer Institute between January 1958 and December 1984. Patients were treated by a variety of approaches, with 48/54 patients receiving some form of radiation therapy. The median potential follow-up was 9 years (rang 1.7-23.7 years). Overall survival and disease-free survival at 10 years were 69% and 48%, respectively. There were no relapses among Stage I patients after 6.5 years, with 11 of 27 patients followed beyond that time, suggesting that some patients may be cured. Of the 38 patients who received radiation therapy alone as primary treatment, 17 ultimately relapsed. Seventy-one percent of these relapses were nodal. Our data suggest that patients with early stage indolent lymphoma can be treated with curative intent. The finding that most relapses after radiation therapy occur in untreated lymph nodes suggests that total lymphoid irradiation may prolong disease-free survival and, perhaps, overall survival as well.