Effect of Radiotherapy on the Survival of Patients With Stage I and Stage II Mantle Cell Lymphoma: Analysis of the Surveillance, Epidemiology and End Results Database

BackgroundRadiotherapy is a treatment option for stage I and stage II MCL. However, data demonstrating the role of RT in a larger patient population and its real world effects are unknown.Materials and MethodsTo demonstrate the role of RT in the OS of patients with stage I and stage II MCL, we performed a retrospective analysis of the SEER database. Included patients were adults with age > 40 years who had MCL stages I and II, and diagnosis between 1992 and 2010. We excluded patients lacking information on demographic characteristics, survival, and RT. Patients were analyzed in 2 groups, those treated with initial RT (RT group) and those not treated with initial RT (no-RT group).ResultsA total of 657 patients were eligible for analysis with 178 patients in the RT group and 479 patients in the no-RT group. The median age of the study group was 68 years. The RT group had a significantly greater proportion of patients with age < 60, male sex, and extranodal disease. Median OS was 103 months in the RT group versus 66 months in the no-RT group (P = .002). On Multivariate analysis, treatment with initial RT was associated with a lower hazard for mortality (hazard ratio, 0.767; 95% confidence interval, 0.602-0.979; P = .033). Age < 60, stage I disease, and extranodal disease were independently associated with a significantly decreased hazard for mortality on Multivariate analysis.ConclusionAlthough stage I and stage II MCL constitute only a small proportion of this disease, our study demonstrates that upfront RT improves the OS of these patients.