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FoRT asked whether two very small doses of radiotherapy control follicular lymphoma as well as the standard twelve; they do not, with about three times the rate of regrowth in the treated area, so 24 Gy stays the standard when the aim is lasting control and 4 Gy is kept for palliation.
FoRT was a UK phase 3 non-inferiority trial that randomised 614 target sites in 548 patients with follicular or marginal zone lymphoma to 24 Gy in 12 fractions or 4 Gy in 2 fractions. The primary endpoint was time to local progression within the irradiated volume; the trial allowed both curative-intent and palliative treatment.
At the first report 4 Gy failed non-inferiority, with a hazard ratio of 3.42 for local progression. Long-term follow-up at a median of 73.8 months confirmed the difference: local progression-free rates were 94.1 percent at two years and 89.9 percent at five years after 24 Gy against 79.8 and 70.4 percent after 4 Gy. The corpus's follicular lymphoma page names involved-site radiotherapy of 24 Gy for localised disease on this evidence, while 4 Gy remains a useful palliative option.
Numbers are from the trial as recorded here; see the source links in the table below. This is orientation, not medical advice: ask your team how closely the trial population matches you.
548 randomised.
95% CI 85.5 to 93.1; 299 sites randomised · 95% CI 64.7 to 75.4; 315 sites randomised
Source95% CI 90.6 to 96.4 · 95% CI 74.8 to 83.9
Source70 local progressions · 21 local progressions; median follow-up 26 months
Source| Endpoint | Arm | n | Value | HR (95% CI) | p | Source |
|---|---|---|---|---|---|---|
| Local progression-free rate at 5 years in the irradiated siteprimary | 24 Gy in 12 fractions | 299 | 89.9% | 3.46 (2.25 to 5.33) | - | link |
| 4 Gy in 2 fractions | 315 | 70.4% | ||||
| Local progression-free rate at 2 years in the irradiated site | 24 Gy in 12 fractions | 299 | 94.1% | - | - | link |
| 4 Gy in 2 fractions | 315 | 79.8% | ||||
| Time to local progression, first analysis (hazard for 4 Gy against 24 Gy) | 4 Gy in 2 fractions | - | 70 local progressions | 3.42 (2.09 to 5.55) | - | link |
| 24 Gy in 12 fractions | - | 21 local progressions; median follow-up 26 months |
Confirms 24 Gy in 12 fractions as the optimal dose for indolent lymphoma when durable local control is the goal.
24 Gy in 12 fractions is the standard radiotherapy dose for indolent lymphoma when durable local control is the aim; 4 Gy remains useful for palliation.
Shares Marginal zone lymphoma, Follicular lymphoma, Non-Hodgkin lymphoma (all types) and the tag soc-trials.
Shares Follicular lymphoma, Non-Hodgkin lymphoma (all types) and the tag soc-trials.
Shares Non-Hodgkin lymphoma (all types) and the tag soc-trials.
Shares Non-Hodgkin lymphoma (all types) and the tag soc-trials.
Shares Non-Hodgkin lymphoma (all types) and the tag soc-trials.
Shares Non-Hodgkin lymphoma (all types) and the tag soc-trials.
Shares Non-Hodgkin lymphoma (all types) and the tag soc-trials.
Shares Non-Hodgkin lymphoma (all types) and the tag soc-trials.