BACKGROUND: Despite international practice guidelines endorsing radiotherapy (RT) as the preferred initial therapy, treatment approaches vary for @entity1 with early-stage @entity706 . The authors engaged the National @entity5 Data Base to analyze patterns of care and survival outcomes for @entity1 with early-stage @entity706 in the era of modern therapy. METHODS: A National @entity5 Data Base retrospective cohort study was conducted of 35,961 @entity1 with lymph node and extranodal, American Joint Committee on @entity5 stage I to II, WHO grade 1 to 2 @entity706 who were diagnosed between 1998 and 2012. Univariate and multivariable analyses were performed to identify sociodemographic, treatment, and @entity5 characteristics that were predictive of @entity1349 ( @entity1349 ) and treatment use. Propensity score-adjusted Cox proportional hazards ratios for survival in @entity1 treated for @entity706 were used. RESULTS: Of the 35,961 @entity1 with @entity706 included in the current study, 63% had stage I disease, 79% were without extranodal disease, and 61% were aged >60 years. RT use decreased from 37% in 1999 to 24% in 2012 (P<.0001), with corresponding significant increases in observation and single-agent chemotherapy. @entity1 who received RT had 5-year and 10-year @entity1349 rates of 86% and 68%, respectively, compared with 74% and 54%, respectively, for those who did not receive RT (P<.0001). On multivariable survival analysis, including a propensity score to account for potential uncaptured confounding variables due to a lack of randomization, upfront RT remained independently associated with improved @entity1349 (hazard ratio of death, 0.54; 95% confidence interval, 0.47-0.63 [P<.0001]). CONCLUSIONS: RT is an increasingly underused treatment approach in the era of modern therapy for @entity1 with early-stage @entity706 . The use of RT appears to improve @entity1349 and should remain standard practice as encouraged by clinical practice guidelines. @entity5 2015;121:3325-3334.    2015 American @entity5 Society.

What is the optimal management of early-stage low-grade XXXX in the modern era?

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients'] @entity5 :: ('MESH:D009369', 'Disease') :: ['tumor', 'Cancer'] @entity706 :: ('MESH:D008223', 'Disease') :: ['follicular lymphoma'] @entity1349 :: ('MESH:D011475', 'Disease') :: ['OS', 'overall survival']
@entity706 :: (MESH:D008223,Disease) :: ['follicular lymphoma']
