Volume 84 � Number 3S � Supplement 2012 Poster Viewing Abstracts S615

transplants (typically an allogeneic HCT following a failed autologous

one), time to recurrence was calculated only with respect to the first

transplant.

Results: Out of 398 eligible NHL patients, 248 received autologous and

150 allogeneic grafts. 35 and 12 patients received IFRT after autologous

and allogeneic HCT, respectively. 51% of allogeneic transplants and all

autologous transplants were myeloablative. IFRT was given for persistent

disease � 2 cm by CT or to sites otherwise suspicious for NHL involve-

ment at the 28 day follow-up. The cumulative incidences of relapse at 1-

and 5- years were 39% and 50% following autologous HCT without IFRT

(n Z 213) compared to 37% and 43% with IFRT (n Z 35, p Z 0.80; p Z0.46). For allogeneic HCT, 1- and 5- year relapse rates were 28% and 31%

without IFRT (n Z 138) compared to 17% and 25% with IFRT (n Z 12, p

Z 0.37; p Z 0.58). Of 113 (auto) and 40 (allo) patients not treated with

IFRT who relapsed, in 37% (auto) and 56% (allo) their first recurrence

included a site of prior nodal disease. Of eight (auto) and four (allo)

patients treated with IFRT who relapsed, 38% (auto) and zero (allo)

patients had a first relapse in an irradiated site. There was a non-significant

trend toward improved overall survival in the small subgroup of myeloa-

blative, allo patients receiving (n Z 6) vs. not receiving (n Z 68) IFRT,

100% vs. 56% at 1 year (p Z 0.06) and 83% vs. 46% at 5 years (p Z0.12).

Conclusions: While consolidative IFRT can be an effective tool for local

control in patients with high-risk NHL in other settings, we demonstrate no

significant benefit in relapse rate, progression-free survival, or overall

survival in patients receiving IFRT following TBI-containing HCT.

Author Disclosure: M.R. Vernon: None. T.E. DeFor: None. L.J. Burns:

None. N.J. Olson: None. V. Bachanova: None. K.E. Dusenbery: None.

3055Radiation Therapy Dose-Response Analysis for Diffuse Large B-cellLymphoma With a Complete Response to ChemotherapyJ.A. Dorth, L. Prosnitz, G. Broadwater, A. Beaven, and C. Kelsey; Duke

University Affiliated Hospitals, Durham, NC

Purpose/Objective(s): To examine the efficacy of different radiation

doses after achievement of a complete response to chemotherapy in diffuse

large B-cell lymphoma (DLBCL).

Materials/Methods: Patients with stage I-IV DLBCL treated from 1995-

2009 who achieved a complete response to chemotherapy were reviewed.

In-field control, event-free survival, and overall survival were calculated

using the Kaplan-Meier method. Dose response was evaluated by grouping

treated sites by delivered radiation dose.

Results: One hundred five patients were treated with RT to 214 disease

sites. Chemotherapy (median 6 cycles) was R-CHOP (65%), CHOP (26%),

R-CNOP (2%), or other (7%). Post-chemotherapy imaging was PET/CT

(88%), gallium with CT (1%), or CT only (11%). The median RT dose was

30 Gy (range, 17-40 Gy). The median radiation dose was higher for

patients with stage I-II disease compared with patients with stage III-IV

disease (30 versus 24.5 Gy, p<0.001). Five-year in-field control, event-free

survival, and overall survival for all patients was 94% (95% CI: 89-99%),

84% (95% CI: 77-92%), and 91% (95% CI: 85-97%), respectively. Six

patients developed an in-field recurrence at 10 sites, without a clear dose

response. In-field failure was higher at sites � 10 cm (14% versus 4%,

pZ0.06).

Conclusions: In-field control was excellent with a combined modality

approach when a complete response was achieved after chemotherapy

without a clear radiation dose response.

Author Disclosure: J.A. Dorth: None. L. Prosnitz: None. G. Broadwater:

None. A. Beaven: None. C. Kelsey: None.

3056Treatment and Outcomes of Patients With Limited Stage PrimaryCutaneous B-cell LymphomaS. Hamilton,1 E. Wai,2 K. Tan,1 C. Alexander,2 R. Gascoyne,1

and J. Connors1; 1British Columbia Cancer Agency, Vancouver, BC,

Canada, 2British Columbia Cancer Agency, Victoria, BC, Canada

Purpose/Objective(s): To review the treatment and outcomes of all

patients with primary cutaneous B-cell lymphoma in one Canadian

province.

Materials/Methods: Prognostic factors, treatment, and outcomes were

analyzed for all patients (pts) referred to the central provincial cancer

organization from August 1, 1981 to August 1, 2011 with Stage I or II

primary cutaneous B-cell lymphoma and no extracutaneous or distant

nodal spread at diagnosis (nZ136). Experienced hematopathologists

reviewed and classified 99% of cases according to the current WHO-

EORTC classification.

Results:Median age at diagnosis was 62 years. Median follow up was 3.9

years. Classification was as follows: 18% diffuse large B-cell leg-type

(DLBCL), 32% follicle center (FOLL), 43% marginal zone (MZL) and

6% non-classifiable pathology (OTHER). Lesion locations were 42%

head/neck, 23% upper limb, 23% trunk, 11% lower limb and 1%

multiple. Performance status was 0-1 in 97% of pts. Lesions were <5 cm

in 80% of pts. Most (93%) of pts had Stage IE disease and 1% had B

symptoms. Of the 111 pts with indolent pathology (FOLL, MZL,

OTHER), 79% received radiation (RT), 11% surgery, 4% chemotherapy

(chemo) and RT, 3% chemo and 3% observation. Of the 92 pts treated

with RT, 22% received <25Gy, 62% received 25-30Gy and 16% received

>30Gy. Complete response (CR) occurred in 94% of pts. One or more

recurrences occurred in 29%. In-field recurrence occurred in 2% of pts

who received RT and was unrelated to dose and in 33% of pts treated

with surgery alone. Recurrences were cutaneous in 70% of pts. Of the 25

pts with DLBCL, 52% received chemoRT, 24% chemo, 20% RT and 4%

surgery. Of the pts treated with RT, 17% received <25Gy, 28% received

25-30Gy and 55% received >30Gy. Most (79%) received CHOP-type

chemo; 47% also received rituximab. CR occurred in 92% of pts. One or

more recurrences occurred in 42%. In-field recurrence occurred in one pt

who received RT and was unrelated to dose. Relapse occurred in 33% of

pts who did not receive chemo and 42% of pts who did. Recurrences

were cutaneous in 71% of pts. For pts with indolent histology, five year

overall survival was 81% and for DLBCL, 26%. Lymphoma-specific

survival at five years was 92% for indolent and 61% for DLBCL.

Progression-free survival (PFS) at five years was 69% for indolent and

54% for DLBCL. On Cox regression analysis of the indolent group, RT

was associated with better PFS (pZ0.037). RT dose, chemo, age at

diagnosis and stage were not significant factors. Cox modeling was not

done for the DLBCL group given the sample size.

Conclusions: This population-based review demonstrates good outcomes

for pts with indolent pathology and worse outcomes for DLBCL. Most of

the indolent group were treated with RT, which was associated with better

PFS and excellent local control. The outcomes are similar to previously

published retrospective reviews.

Author Disclosure: S. Hamilton: None. E. Wai: None. K. Tan: None. C.

Alexander: None. R. Gascoyne: None. J. Connors: None.

3057Clinical Characteristics and Use of Radiation Therapy for theManagement of Plasmablastic Lymphoma (PBL): A PopulationBased StudyV. Valakh,1 B. Micaily,1 C. Miyamoto,1 and O.O. Fasan2; 1Temple

University Hospital, Philadelphia, PA, 2Fox Chase Cancer Center/Temple

University Hospital, Philadelphia, PA

Purpose/Objective(s): PBL is a distinct aggressive type of B-cell

neoplasm strongly associated with human immunodeficiency virus (HIV)

infection. Since published data on PBL are limited due to low incidence,

we analyzed characteristics of PBL using Surveillance, Epidemiology and

End Results (SEER) registry.

Materials/Methods: SEER database contained a total of 154 patients with

HIV infection, which between 1995 and 2008 were diagnosed with

lymphoma classified as PBL. Demographic, clinical and treatment data

were extracted. The overall survival was estimated by the Kaplan - Meier

method and compared between groups using log-rank test.

International Journal of Radiation Oncology � Biology � PhysicsS616

Results: Median age at diagnosis was 41 years (range, 13-73). Male to

female ratio was 18:1 and race was white in 80.5%. The most common

primary sites were coded as head and neck, gastrointestinal tract, central

nervous system and lymph nodes. Consistently with the known dichotomy

for PBL, 59.7% had Ann Arbor stage IV lymphoma while 33.4% had stage

I. For the entire study the median overall survival was 3 months (95%

confidence intervals, 2-4 months) with the overall survival of 20.8% at 1

year and 13% at 2 years. For stage I, 1 year overall survival was 22.6% vs.

21.7% for stage IV (pZ0.323). External beam radiation therapy was

administered with the initial treatment course to 38/154 patients (24.7%),

including 45.3% of stage I patients. Cox proportional hazards modeling

revealed no statistically significant association between radiation therapy

and the overall survival. For stage I patients treated with radiation therapy,

1 year overall survival was 20.7% vs. 20.8% without radiation therapy

(pZ0.457).

Conclusions: Survival for HIV positive PBL was extremely poor, which

may indicate that effective and tolerable treatment regimen has not been

established. Radiation therapy use was not associated with survival. In this

study a minority of patients received irradiation with the initial course of

therapy.

Author Disclosure: V. Valakh: None. B. Micaily: None. C. Miyamoto:

None. O.O. Fasan: None.

3058Dosimetric Comparison of Conventional Radiation Therapy,3-dimensional Conformal Radiation Therapy and IntensityModulated Radiation Therapy for Non-Hodgkin Lymphoma in PelvisZ. Tao, C. Yang, B. Zhang, W. Wang, Z. Yuan, and L. Zhao; Tianjin

Medical University Cancer Institute and Hospital, Tianjin, China

Purpose/Objective(s): To investigate the potential advantage and dose

distribution for intensity-modulated radiation therapy in the treatment of

non-Hodgkin lymphoma involving the pelvic with regards to organ-at-risk

(OAR) avoidance.

Materials/Methods: Eight patients with large B-cell lymphoma were

evaluated. For each patient, intensity-modulated radiation therapy,

conventional parallel-opposed(AP-PA), and three dimensional conformal

radiation therapy(3D-CRT) plans were designed using 6-MV X-rays to

deliver doses of 45Gy. The planning target volume and organ-at-risk (small

bowel, rectum, bladder and femoral head) dose-volume histograms

(DVHs) were analyzed. The inhomogeneity coefficient(IC) of different

plans, the PTV receiving 95% the prescription dose(D95), the normal

tissue complication probability(NTCP) and the dose volume parameters

for the OARs were calculated.

Results: The planning target volume coverage was improved by using

IMRT compared with AP-PA, but was not different from that obtained by

3D-CRT (ICAP-PA Z 0.16 vs. IC3D-CRTZ0.11 vs. ICIMRTZ0.10, P<0.05).

The average volumes of small bowel irradiated to 45Gy were 68�21cc,

98�29cc and 261�17cc in IMRT, 3D-CRT and AP-PA, respectively. The

V40 and V45 of bladder, rectum and femoral head were significantly

reduced by IMRT compared with 3D-CRT and AP-PA. There were no

statistical differences between the three techniques with respect to OARs

receiving low radiation doses.

Conclusions: Compared with AP-PA, 3D-CRT and IMRT are superior in

sparing OARs, with adequate coverage of planning target volume.

Author Disclosure: Z. Tao: None. C. Yang: None. B. Zhang: None. W.

Wang: None. Z. Yuan: None. L. Zhao: None.

3059Elevated Beta2-microglobulin Level is an Adverse Prognostic Factorfor Patients With Extranodal Nasal-type NK/T-cell LymphomaX. Zhang, Y. Li, S. Wang, W. Wang, J. Jin, Y. Liu, Y. Song, X. Liu,

and Z. Yu; Department of Radiation Oncology, Cancer Hospital, Chinese

Academy of Medical Sciences (CAMS) and Peking Union Medical College

(PUMC), Beijing, China

Purpose/Objective(s): The prognostic value of clinical features have beenclearly defined in patients with extranodal NK/T-cell lymphoma. It is

necessary to explore new prognostic biomarkers and their clinical

relevance.

Materials/Methods: A total of 158 patients diagnosed with extranodal

NK/T-cell lymphoma of upper aerodigestive tract (UADT-NKTCL) were

retrospectively analyzed. There were 116 cases of stage I, 38 cases of stage

II and 4 cases of stage IV disease. Sixty-five patients received radiation

therapy alone, 10 patients received chemotherapy alone and the remaining

84 patients received combined treatment of radiation therapy and

chemotherapy.

Results: Patients with elevated beta2-microglobulin (b-2 MG) (>2.2 mg/

L) at diagnosis tended to have more adverse clinical features: B symptoms

(48%), high lactate dehydrogenase (LDH) (53%) and high-risk of inter-

national prognostic index (IPI) score (>1, 18%). Patients with higher b-2MG had shorter 5-year overall survival (OS) compared with patients with

normal b-2 MG (61.9% vs 74.4%; PZ0.048). Multivariate analysis

showed that b-2 MG, globulin and regional lymph nodes involvement were

independent prognostic factors for survival. The 5-year OS for patients

with no adverse factor, one adverse factor and two and more adverse

factors were 79.3%, 66.4% and 53.5%, respectively. (P �0.001).

Conclusions: Our data suggest that b-2 MG is an independent prognostic

factor in extranodal nasal-type NK/T-cell lymphoma. Future prognostic

model with incorporation of b-2 MG should allow for better identification

of high risk group in patients with UADT-NKTCL.

Author Disclosure: X. Zhang: None. Y. Li: None. S. Wang: None. W.

Wang: None. J. Jin: None. Y. Liu: None. Y. Song: None. X. Liu: None. Z.

Yu: None.

3060Clinical Features and Treatment Outcomes of Patients With PrimarySystemic Anaplastic Large Cell Lymphoma: Report From a SingleInstitution in ChinaX. Zhang,1 Y. Li,1 S. Wang,1 W. Wang,1 J. Jin,1 Y. Liu,1 Y. Song,1 X. Liu,1

L. Zhou,2 and Z. Yu1; 1Department of Radiation Oncology, Cancer

Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking

Union Medical College (PUMC), Beijing, P.R. China, Beijing, China,2Department of Medical Oncology, Cancer Hospital, Chinese Academy of

Medical Sciences (CAMS) and Peking Union Medical College (PUMC),

Beijing, P.R. China, Beijing, China

Purpose/Objective(s): This study aims to analyze the clinical features

and treatment outcomes in patients with primary systemic anaplastic large

cell lymphoma (ALCL) in a single institution from China.

Materials/Methods: A total of 106 patients were included. There were 22

patients with stage I disease, 36 patients with stage II disease, 26 patients

with stage III disease and 22 patients with stage IV disease. Patients with

early stage received chemotherapy followed by radiation therapy, whereas

patients with advanced stage received primary chemotherapy with or

without irradiation to the primary or residual tumor.

Results: Compared with European studies, patients in this study tended to

be young, good performance status, early stage, and less extranodal

disease. The 5-year overall survival (OS) and progression-free survival

(PFS) of the whole series were 70.5% and 55.4%, respectively. The 5-year

OS and PFS rates were 92.7% and 79.8% for patients 21 years old or

younger compared with 64.0% and 47.6% for patients more than 21 years

old (PZ0.020 for OS, PZ0.017 for PFS). Patients with CR showed

favorable prognosis compared with those with non-CR (P < 0.001 for OS

and PFS). Of 106 patients, 44 were ALK positive ALCL, 34 were ALK

negative ALCL and 28 were unavailable for ALK status. Compared with

ALK- ALCL patients, ALK+ ALCL showed a superior OS and PFS

(PZ0.073 for OS, PZ0.026 for PFS).

Conclusions: The clinical features of primary systemic ALCL in Chinese

patients were different from that of ALCL in Europe, however, survivals

were comparable. Patients with early stage disease, age younger than 22

years old, IPI score of 0-1, expression of the ALK protein and CR after

therapy had favorable prognosis.