Combination of chemotherapy and radiotherapy improves the cure rate in primary extranodal lymphomas of the head and neck (PLHN)

Background: Since PLHN are rare, prognostic factors and the therapeutic strategy have not yet been clearly assessed. Patients and Methods. Seventy-one patients with PLHN (44 stage 1, 27 stage II; 54 with high-grade histology) received the following treatments. 5 radical surgery, 21 radiotherapy, 43 combined treatment (mainly chemotherapy plus radiotherapy) (CT) and 1 was not treated. Results. Disease-related survival (DRS) and disease-free survival (DFS) were 84% and 69% at 5 years and 70% and 56% at 10 years. CT provided significantly better DRS and DFS than radiotherapy alone (92% and 81% vs 70% and 43% respectively), though the group receiving the CT included most of the patients with high-grade histology (37) and stage II (20). Outcome was not influenced by stage and site of involvement (Waldeyer's ring vs non-Waldeyer's ring). Multivariate analysis showed that favourable prognostic factors were age for DRS, high-grade histology and CT for DFS. Conclusions: patients receiving the CT fared significantly better, though most of them had high-grade histology and stage II.