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Leo I. Gordon, MD, FACP


ASTRO 2022: Novel Response-Adapted Approach to Treatment of Orbital B-Cell Lymphoma

By: Emily Rhode
Posted: Wednesday, October 26, 2022

Findings from a phase II prospective study, presented at the 2022 American Society for Radiation Oncology (ASTRO) Annual Meeting (Abstract 3), suggest that response-adapted ultra–low-dose radiation therapy may provide disease control for patients with orbital indolent B-cell lymphoma. Chelsea C. Pinnix, MD, PhD, of The University of Texas MD Anderson Cancer Center, Houston, and colleagues also noted that along with a 90% complete response rate, treatment was well tolerated.

“The vast majority of patients were able to avoid additional radiation doses, which minimizes potential orbital toxicity commonly associated with current standard doses,” Dr. Pinnix commented in an MD Anderson press release.

The study enrolled 50 eligible patients with mucosa-associated lymphoid tissue (MALT) lymphoma, follicular lymphoma, or low-grade B-cell lymphoma, a majority of whom had stage I disease (n = 31). Patients received ultra–low-dose radiation therapy to 4 Gy over two fractions. Treatment response was assessed at intervals of 3 months.

The complete response rate after a median follow-up of 35 months was 90% (n = 45), with 44 patients exhibiting a complete response to ultra–low-dose radiation therapy and one patient exhibiting a complete response after receiving an additional 20 Gy in 10 fractions. Results from the analysis of a planned subset of 26 patients showed that the 3-year rate of freedom from distant relapse for newly diagnosed patients with stage I disease was 90.4%.

In a separate retrospective study of a cohort of 55 patients undergoing this treatment strategy, the median follow-up was 28.7 months. Among this cohort, 98% (n = 54) had a complete response to response-adapted radiation therapy, with one patient having a complete response to an additional 20 Gy of radiation. There was one local relapse of disease in a patient who had experienced a complete response to ultra–low-dose radiation; it was resolved after treatment with 20 Gy of radiation.   

Disclosure: To view full disclosures for Dr. Pinnix, visit

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