Lymphoma Cases Referred to the Radiation Oncology Service of a Tertiary Referral University Hospital in Karachi, Pakistan: a Retrospective Study

Introduction: Radiation therapy is an important component of curative therapy for Lymphoma [Hodgkin’sdisease (HD) and non Hodgkin’s Lymphoma (NHL)]. The current study was conducted to give us an overview oflymphoma patients presenting to a tertiary care hospital for complementary adjuvant RT.
Method: Data oflymphoma patients who underwent radiotherapy during February 2006 till August 2009 at the department ofradiation oncology, Aga Khan University, Hospital, Karachi was retrieved from the medical records and analyzedusing SPSS (version 16.0).
Results: A total of 1,678 cancer patients were registered, 75 (0.45%) were lymphomapatients (25.3% HD; 74.7% NHL). HD and NHL were both seen predominantly in males, with a male:femaleratio of 2 and 3 respectively. Nodal HD comprised 94.7% and nodal NHL comprised 41.1%. Extranodal NHL(EN-NHL) comprised 53.6% whereas 5.4% cases had both nodal and EN-NHL; 6.7% of EN-NHL were primaryCNS lymphomas. Stages of presentation for HD were IIA (52.6%), 1A (21.1%), IIB (10.5%) and IB, IIIB andIVA collectively 15.9%. The ages of HD patients ranged from 11 to 54 years (median 23.5 years ± 13.2 SD).Response to therapy for HD was 52.6% complete remission, 36.8% partial response, and 5.3% each with stableand progressive disease. Almost all patients (94.7%) received radical treatment with radiation doses (between1950 cG to 5404 cGy) with a median of 40 Grays.Stages at presentation for NHL were II (23.2%), IV (21.4%)and IE (17.9%); I, IIE, and III were found to be 12.5 %. NHL patients ranged from 15 to 88 years. It was morecommonly observed amongst the elderly with 25% diagnosed in the fifth decade of life; 50% patients aged at orabove 50 years, 41.1% belonged to the 25-49 years age group and 8.9% below 25 years of age. Majority of thecases were diffuse NHL (82.1%), follicular NHL (7.1%), ‘Primary CNS unclassified type (8.9%), and unclassifiedother than CNS variety (1.8%). Response to chemotherapy for NHL was 51.8% complete remission, 25.9%progressive disease, 20.4% partial response. Forty (71.4%) with NHL received radical treatment with radiationdoses between 2340 cG to 6600 cGy; 28.6% received palliative RT.
Conclusion: Radiation therapy, thoughimportant for cure of lymphoma, is relatively underutilized in our population, despite encouraging outcomes.