ArticleBlood advances2021
Excellent response to very-low-dose radiation (4 Gy) for indolent B-cell lymphomas: is 4 Gy suitable for curable patients?
Article in Blood advances, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
21 citing papers in PubMed, 1 synthesis or guideline pooled it, 37 citations in OpenAlex.
- Guidelines for Diagnosis, Treatment, and Follow-Up of Patients with Follicular Lymphoma-Spanish Lymphoma Group (GELTAMO) 2025.Cancers · 2026Guideline
- Response-adapted ultra-low-dose 4 Gy radiation as definitive therapy of gastric MALT lymphoma: a single-centre, pilot trial.The Lancet. Haematology · 2024Trial
- Association of age and primary treatment with risk of non-lymphoma-related death and long-term survival outcomes in adult patients with early-stage follicular lymphoma: a population-based analysis.Annals of hematology · 2026Article
- First Comprehensive Characterization of Lip Lymphoma: A Population-Based Study.Acta haematologica · 2026Article
- Salvage ultra-low-dose radiotherapy for conjunctival mantle cell lymphoma - a case report and literature review.Reports of practical oncology and radiotherapy : journal of Greatpoland Cancer Center in Poznan and Polish Society of Radiation Oncology · 2026Article
- Immune-sparing potential of isocentric lateral decubitus positioning in adjuvant whole-breast radiotherapy.Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] · 2025Article
- Initial local treatment strategies on survival outcomes of early-stage breast mucosa-associated lymphoid tissue lymphoma.Annals of hematology · 2025Article
- New workflow and motion analysis for gastric mucosa-associated lymphoid tissue lymphoma on a 1.5-T MR-Linac.Technical innovations & patient support in radiation oncology · 2025Article
- Clinical Outcomes and Safety of Ultra-Low-Dose Radiotherapy for Ocular Adnexal Lymphoma: A Systematic Review.Cancers · 2025Review
- Follicular lymphoma: contemporary clinical management with a focus on recent therapeutic advances.The Korean journal of internal medicine · 2025Review
- Management approaches for primary hepatic lymphoma: 10 year institutional experience with comprehensive literature review.Frontiers in oncology · 2025Article
- Ultra-Low-Dose Radiation for Extranodal Marginal Zone Lymphoma of the Lung.Advances in radiation oncology · 2024Article
- Personalised therapy in follicular lymphoma - is the dial turning?Hematological oncology · 2024Review
- The clinical regimens and cell membrane camouflaged nanodrug delivery systems in hematologic malignancies treatment.Frontiers in pharmacology · 2024Review
- Very low-dose radiotherapy for extranodal marginal zone lymphoma of bronchus-associated lymphoid tissue.Leukemia & lymphoma · 2023Article
- Article
- Predictors of survival in patients with MALT lymphoma: a retrospective, case-control study.Blood advances · 2023Review
- Prospective Study of 4 Gy Radiotherapy for Orbital Mucosa-Associated Lymphoid Tissue Lymphoma (FORMAL).Cancers · 2022Article
- Trends in Use of and Medicare Spending on Short-Course Radiotherapy for Lymphomas From 2015 to 2019.JAMA health forum · 2022Article
- Mucosa-Associated Lymphoid Tissue (MALT) Lymphoma in the Gastrointestinal Tract in the Modern Era.Cancers · 2022Review
Corrections and comments
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Authors and funding
18 authors at 3 institutions in 2 countries.
Funding
Abstract
Radiotherapy plays an important role in managing highly radiosensitive, indolent non-Hodgkin lymphomas, such as follicular lymphoma and marginal zone lymphoma. Although the standard of care for localized indolent non-Hodgkin lymphomas remains 24 Gy, de-escalation to very-low-dose radiotherapy (VLDRT) of 4 Gy further reduces toxicities and duration of treatment. Use of VLDRT outside palliative indications remains controversial; however, we hypothesize that it may be sufficient for most lesions. We present the largest single-institution VLDRT experience of adult patients with follicular lymphoma or marginal zone lymphoma treated between 2005 and 2018 (299 lesions; 250 patients) using modern principles including positron emission tomography staging and involved site radiotherapy. Outcomes include best clinical or radiographic response between 1.5 and 6 months after VLDRT and cumulative incidence of local progression (LP) with death as the only competing risk. After VLDRT, the overall response rate was 90% for all treated sites, with 68% achieving complete response (CR). With a median follow-up of 2.4 years, the 2-year cumulative incidence of LP was 25% for the entire cohort and 9% after first-line treatment with VLDRT for potentially curable, localized disease. Lesion size >6 cm was associated with lower odds of attaining a CR and greater risk of LP. There was no suggestion of inferior outcomes for potentially curable lesions. Given the clinical versatility of VLDRT, we propose to implement a novel, incremental, adaptive involved site radiotherapy strategy in which patients will be treated initially with VLDRT, reserving full-dose treatment for those who are unable to attain a CR.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.