Primary Gastric Lymphoma
ICD-10 C85.7 · ICD-11 2B33.5&XA7MC7

Gastric MALT Lymphoma Without H. pylori: When Antibiotic Therapy Does Not Achieve Remission

This protocol addresses gastric MALT-type lymphoma in patients without Helicobacter pylori infection. Almost 10% of MALT lymphomas are unrelated to H. pylori, and the pathogenesis in this subgroup remains unclear.

Previous Line — Treatment Goal Not Reached

Antibiotic therapy was administered as the initial approach. However, remission of the gastric MALT lymphoma was not achieved — responses are typically expected between 3 and 9 months. Failure to reach remission is the trigger for escalation to this next treatment step.

Next-Line Approach (Partial Overview)

The structured protocol for this situation centres on a targeted form of radiation therapy directed at the involved field. The complete regimen parameters are defined in the full protocol.

References

Almost 10% of MALT lymphomas are unrelated to H pylori infection, and the pathogenesis remains unclear.

Therefore, "involved-field" irradiation (total dose of 30 Gy administered over 4 weeks) has continued to be the preferred treatment for patients with stage I and stage II MALT lymphomas without H pylori or with persistent lymphomas following antibiotic therapy.

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