Castleman disease is a rare
lymphoproliferative disorder. Surgery is considered standard
therapy for the unicentric type. However, case reports have documented favorable responses to
radiotherapy. The aim of this study was to analyse the clinical outcomes of five patients with unicentric
Castleman disease treated with
radiotherapy between 1991 and 2005. Mediastinal lymph nodes were the most common site of disease (four patients). Three patients were treated with
radiotherapy alone, two patients with surgery and
radiotherapy. Patients were treated with
radiotherapy doses ranging from 40 Gy to 50 Gy. The median follow-up was 12 months (range, 3-175 months). During follow-up only one patient had progressive disease and died of
Castleman disease. At the time of last follow-up two patients were
in complete remission, one patient in partial remission, and one patient had stable disease. One patient showed serious acute and late toxicities. At the end of
radiotherapy a paraneoplastic
pemphigus vulgaris occurred, and eight to 11 months after
radiotherapy a
stenosis of the esophagus, of the left bronchus, and of the trachea due to
scars. The study shows that unicentric
Castleman disease is successfully treated with
radiotherapy. However, for detection of possible complications as
pemphigus vulgaris or
stenosis of the esophagus or trachea an accurate follow-up is necessary.