RESULTS OF A MULTICENTER PHASE2 TRIAL OF INVOLVED FIELD RADIOTHERAPY ALONE FOR LOCALIZED NON‐GASTRIC MARGINAL ZONE LYMPHOMA: TROG 05.02
Bibliographic record
Abstract
Introduction: We conducted the first prospective phase 2 multicenter clinical trial to assess the long term efficacy and safety of radiotherapy for localized non-gastric marginal zone lymphoma (MZL) and documented the prevalence of autoantibodies, autoimmune events and Helicobacter Pylori (HP) infection in this population. Methods: Eligible patients had untreated stage I or II, or paired-organ confined, non-gastric marginal zone lymphoma. Mandatory investigations included CT and bone marrow aspirate and trephine, autoantibody panel and HP evaluation. FDG-PET was optional. Involved-field or site, conventionally-fractionated radiotherapy was delivered to 30-30.6 Gy, except for orbital MZL which received 24-25 Gy. Results: Six centres enrolled 70 patients. Two patients were ineligible after registration: 68 patients commenced protocol treatment. Median age was 59 (range: 23-84) and 31 (46%) were male. Stage was I n = 55, II n = 9 and IV n = 4. Sites were orbital n = 18, conjunctiva n = 13, lacrimal n = 8, skin n = 8, primary nodal n = 8, salivary n = 7, muscle n = 3 and 15 other extranodal sites with single cases of each. Four patients (6%) had paired organ (salivary or orbital) MZL. Fourteen (21%) were PET-staged. Median follow-up was 5 years (range 0.7 – 9.4). At 7 years, freedom from progression and overall survival were 79% (95% CI: 67-93) (Figure) and 95% (95% CI: 89-100) respectively. One transformation to diffuse large B cell lymphoma occurred. There was one lymphoma-related death and 2 in-field failures (after 25 and 30 Gy respectively). Out-of-field relapse sites were skin (n = 2) duodenum, stomach, paravertebral muscle and conjunctiva. No patient with paired organ disease relapsed. Acute toxicity > grade 3 occurred in 7 cases. Apart from cataracts (n = 18), there were 6 late grade 3 adverse events. Two grade 4 late events (nephrotic syndrome and catheter thrombosis) and two second malignancies were not treatment-related. Autoantibodies or auto-immune events were detected in 26 of 68 (38%) patients. HP infection was detected (and treated) in 15 of 63 patients tested (24%). Neither autoimmunity or HP was detected in 27/68 (40%) patients. Conclusions: Most patients with localized non-gastric MZL had either evidence of autoimmunity or HP infection or both and RT was a highly effective treatment associated with low toxicity and excellent survival.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".