Radiation therapy (RT) alone was highly effective for the treatment of Helicobacter pylori–independent gastric mucosa-associated lymphoid tissue lymphoma (GML), according to the results of a single-center retrospective study published in Blood Advances.

“Given the indolent course of disease progression, as well as changes in radiation technology…we sought to update our experience of treating  H pylori–independent GML with radiation…” the authors stated.

The retrospective study analyzed data from 178 patients with H pylori–independent GML diagnosed from November 1991 to March 2017 at a single tertiary care center. All patients underwent involved-site RT to the stomach, and response was assessed after 10 to 12 weeks by endoscopy and at various intervals thereafter.

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The median age of the cohort was 63.5 years, and 56% of patients were women. The time from diagnosis to RT was a median of 4.5 months. The majority of patients had Lugano disease stage I at 86%, followed by 7% each with stage II or IV disease.

Local disease failures were uncommon during the median 6.2-year follow-up. There were 7% of patients with early-stage disease who developed local disease failure, with a 5- and 10-year local failure rate of 3.9% and 8.3%, respectively.

During a median follow-up of 6.5 years, the median overall survival was 16.5 years, which translated to a 5- and 10-year rate of 94% and 79%, respectively.

The overall median progression-free survival (PFS) was 13.8 years. When stratified by disease stage, the median PFS was 13.8, 8.9, or 1.7 years for stage I, II, or IV at presentation, respectively.

Later-stage disease at presentation was significantly associated with a shorter PFS, with a hazard ratio (HR) of 7.5 (95% CI, 3.5-15.8) for stage IV disease compared with an HR of 1.7 (95% CI, 0.8-3.8) for stage II disease (P <.001).

Treatment-related toxicities were rare according to the authors, with 1% of patients developing a grade 3 esophageal stricture that required dilation and 1.6% developing a secondary malignancy within the radiation field. Dyspepsia was the most common side effect, which was treated with proton pump inhibitors.

The authors concluded that “RT is a highly effective and safe treatment of GML with excellent overall survival and very rare acute or late treatment-related toxicities.”

Disclosures: One of the study authors declared an affiliation with the pharmaceutical industry. Please see original reference for a full list of authors’ disclosures.


Yahalom J, Xu AJ, Noy A, et al. Involved-site radiotherapy for Helicobacter pylori–independent gastric MALT lymphoma: 26 years of experience with 178 patients. Blood Adv. 2021;5(7):1830-1836. doi:10.1182/bloodadvances.2020003992

This article originally appeared on Cancer Therapy Advisor