{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T03:39:58Z","timestamp":1790739598975,"version":"4.1.0"},"reference-count":39,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"27","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCO"],"published-print":{"date-parts":[[2012,9,20]]},"abstract":"<jats:sec><jats:title>Purpose<\/jats:title><jats:p>The optimal management of stage I follicular lymphoma, according to consensus guidelines, is based on uncontrolled experiences of select institutions. Diverse treatment approaches are used despite guidelines that recommend radiation therapy (XRT).<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients and Methods<\/jats:title><jats:p>We analyzed outcomes of patients with stage I follicular lymphoma enrolled onto the National LymphoCare database.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 471 patients with stage I follicular lymphoma, 206 patients underwent rigorous staging as defined by both a bone marrow aspirate and biopsy and an imaging study (a computed tomography [CT] scan of the whole body, a positron emission tomography [PET]\/CT scan, or both). Rigorously staged patients had superior progression-free survival (PFS) compared with nonrigorously staged patients (hazard ratio [HR], 0.63). Treatments given to rigorously staged patients were rituximab\/chemotherapy (R-chemo; 28%), XRT (27%), observation (17%), systemic therapy + XRT (13%), rituximab monotherapy (12%), and other (3%). With a median follow-up of 57 months for PFS, there were 44 progression events (in 21% of patients) for rigorously staged patients. For these patients, PFS was significantly improved with either R-chemo or systemic therapy + XRT compared with patients receiving XRT alone after adjustment for histology, LDH, and the presence of B symptoms. There were no differences in overall survival.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In this largest, prospectively enrolled group of patients with stage I follicular lymphoma, variable treatment approaches resulted in similar excellent outcomes, which challenges the paradigm that XRT should be standard for this presentation.<\/jats:p><\/jats:sec>","DOI":"10.1200\/jco.2011.40.6546","type":"journal-article","created":{"date-parts":[[2012,8,21]],"date-time":"2012-08-21T04:41:09Z","timestamp":1345524069000},"page":"3368-3375","source":"Crossref","is-referenced-by-count":165,"title":["Effectiveness of First-Line Management Strategies for Stage I Follicular Lymphoma: Analysis of the National LymphoCare Study"],"prefix":"10.1200","volume":"30","author":[{"given":"Jonathan W.","family":"Friedberg","sequence":"first","affiliation":[{"name":"Jonathan W. Friedberg, University of Rochester, Rochester; Andrew D.Zelenetz, Memorial Sloan-Kettering Cancer Center, New York, NY; Michelle Byrtek, Michael Taylor, and Jamie Hirata, Genentech, South San Francisco, CA; Brian K. Link, University of Iowa, Iowa City, IA; Christopher Flowers, Emory University, Atlanta, GA; John Hainsworth, Sarah Cannon Cancer Center, Nashville, TN; James R. Cerhan, Mayo Clinic, Rochester, MN; Thomas P. Miller, Arizona Cancer Center, Tucson, AZ."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle","family":"Byrtek","sequence":"additional","affiliation":[{"name":"Jonathan W. Friedberg, University of Rochester, Rochester; Andrew D.Zelenetz, Memorial Sloan-Kettering Cancer Center, New York, NY; Michelle Byrtek, Michael Taylor, and Jamie Hirata, Genentech, South San Francisco, CA; Brian K. Link, University of Iowa, Iowa City, IA; Christopher Flowers, Emory University, Atlanta, GA; John Hainsworth, Sarah Cannon Cancer Center, Nashville, TN; James R. Cerhan, Mayo Clinic, Rochester, MN; Thomas P. Miller, Arizona Cancer Center, Tucson, AZ."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian K.","family":"Link","sequence":"additional","affiliation":[{"name":"Jonathan W. Friedberg, University of Rochester, Rochester; Andrew D.Zelenetz, Memorial Sloan-Kettering Cancer Center, New York, NY; Michelle Byrtek, Michael Taylor, and Jamie Hirata, Genentech, South San Francisco, CA; Brian K. Link, University of Iowa, Iowa City, IA; Christopher Flowers, Emory University, Atlanta, GA; John Hainsworth, Sarah Cannon Cancer Center, Nashville, TN; James R. Cerhan, Mayo Clinic, Rochester, MN; Thomas P. Miller, Arizona Cancer Center, Tucson, AZ."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Flowers","sequence":"additional","affiliation":[{"name":"Jonathan W. Friedberg, University of Rochester, Rochester; Andrew D.Zelenetz, Memorial Sloan-Kettering Cancer Center, New York, NY; Michelle Byrtek, Michael Taylor, and Jamie Hirata, Genentech, South San Francisco, CA; Brian K. Link, University of Iowa, Iowa City, IA; Christopher Flowers, Emory University, Atlanta, GA; John Hainsworth, Sarah Cannon Cancer Center, Nashville, TN; James R. Cerhan, Mayo Clinic, Rochester, MN; Thomas P. Miller, Arizona Cancer Center, Tucson, AZ."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Taylor","sequence":"additional","affiliation":[{"name":"Jonathan W. Friedberg, University of Rochester, Rochester; Andrew D.Zelenetz, Memorial Sloan-Kettering Cancer Center, New York, NY; Michelle Byrtek, Michael Taylor, and Jamie Hirata, Genentech, South San Francisco, CA; Brian K. Link, University of Iowa, Iowa City, IA; Christopher Flowers, Emory University, Atlanta, GA; John Hainsworth, Sarah Cannon Cancer Center, Nashville, TN; James R. Cerhan, Mayo Clinic, Rochester, MN; Thomas P. Miller, Arizona Cancer Center, Tucson, AZ."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Hainsworth","sequence":"additional","affiliation":[{"name":"Jonathan W. Friedberg, University of Rochester, Rochester; Andrew D.Zelenetz, Memorial Sloan-Kettering Cancer Center, New York, NY; Michelle Byrtek, Michael Taylor, and Jamie Hirata, Genentech, South San Francisco, CA; Brian K. Link, University of Iowa, Iowa City, IA; Christopher Flowers, Emory University, Atlanta, GA; John Hainsworth, Sarah Cannon Cancer Center, Nashville, TN; James R. Cerhan, Mayo Clinic, Rochester, MN; Thomas P. Miller, Arizona Cancer Center, Tucson, AZ."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James R.","family":"Cerhan","sequence":"additional","affiliation":[{"name":"Jonathan W. Friedberg, University of Rochester, Rochester; Andrew D.Zelenetz, Memorial Sloan-Kettering Cancer Center, New York, NY; Michelle Byrtek, Michael Taylor, and Jamie Hirata, Genentech, South San Francisco, CA; Brian K. Link, University of Iowa, Iowa City, IA; Christopher Flowers, Emory University, Atlanta, GA; John Hainsworth, Sarah Cannon Cancer Center, Nashville, TN; James R. Cerhan, Mayo Clinic, Rochester, MN; Thomas P. Miller, Arizona Cancer Center, Tucson, AZ."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew D.","family":"Zelenetz","sequence":"additional","affiliation":[{"name":"Jonathan W. Friedberg, University of Rochester, Rochester; Andrew D.Zelenetz, Memorial Sloan-Kettering Cancer Center, New York, NY; Michelle Byrtek, Michael Taylor, and Jamie Hirata, Genentech, South San Francisco, CA; Brian K. Link, University of Iowa, Iowa City, IA; Christopher Flowers, Emory University, Atlanta, GA; John Hainsworth, Sarah Cannon Cancer Center, Nashville, TN; James R. Cerhan, Mayo Clinic, Rochester, MN; Thomas P. Miller, Arizona Cancer Center, Tucson, AZ."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jamie","family":"Hirata","sequence":"additional","affiliation":[{"name":"Jonathan W. Friedberg, University of Rochester, Rochester; Andrew D.Zelenetz, Memorial Sloan-Kettering Cancer Center, New York, NY; Michelle Byrtek, Michael Taylor, and Jamie Hirata, Genentech, South San Francisco, CA; Brian K. Link, University of Iowa, Iowa City, IA; Christopher Flowers, Emory University, Atlanta, GA; John Hainsworth, Sarah Cannon Cancer Center, Nashville, TN; James R. Cerhan, Mayo Clinic, Rochester, MN; Thomas P. 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