A trial looking at radiotherapy for people with follicular lymphoma or marginal zone lymphoma (FORT)

Cancer type:

Blood cancers
Low grade lymphoma
Non-Hodgkin lymphoma




Phase 3

This trial compared low dose radiotherapy with standard radiotherapy for people with follicular lymphoma or marginal zone lymphoma. This trial was supported by Cancer Research UK.

Follicular lymphoma is a type of Non Hodgkin lymphoma (NHL). Marginal zone lymphoma is another type of NHL. It can grow in the lymph nodes Open a glossary item, but usually starts outside the lymphatic system. Marginal zone lymphoma includes MALT lymphoma and splenic lymphoma, which starts in the spleen Open a glossary item.

People with lymphoma may have treatment with radiotherapy. Doctors use radiotherapy to cure lymphoma, or to control the growth of the cancer and to relieve symptoms (sometimes called palliative radiotherapy).

Your total dose of radiotherapy is usually divided into a series of daily doses called fractions. Earlier trials looking at radiotherapy for follicular NHL have shown that 12 fractions worked well and was safe. This is the standard treatment. But more recent trials suggested that similar results may be possible with fewer fractions and a smaller overall dose of radiotherapy.

The aim of this trial was to see if a lower dose (with fewer fractions) of radiotherapy worked as well as standard radiotherapy, and whether it caused fewer side effects.

Summary of results

The trial team found that the standard radiotherapy was better at treating follicular lymphoma and marginal zone lymphoma than the lower dose treatment.  

This trial recruited 548 people. It was a randomised trial. Neither the people taking part, nor their doctors could decide which treatment they had.

If the people taking part had lymphoma in more than 1 part of their body, they could have radiotherapy to more than 1 area of the body. The researchers call each area of lymphoma that was treated a ‘site’.

  • 299 sites were treated with standard radiotherapy
  • 315 sites had the lower dose of radiotherapy

After 12 weeks of radiotherapy the researchers looked at the sites of lymphoma to see how well they had responded. For the standard radiotherapy, it was 91 out of every 100 sites (91%). For the lower dose of radiotherapy, it was 81 out of every 100 sites (81%).  

After following up the people taking part for an average of just over 2 years, the trial team looked at how many of the treated sites of lymphoma had started growing again. They found it was

  • 21 of the 299 sites treated with standard radiotherapy
  • 70 of the 315 sites treated with lower dose radiotherapy

There were fewer side effects reported in the lower dose treatment group than the standard treatment group.

There was no difference in overall survival between the two treatment groups.

The trial team concluded that both treatments are safe and worked well. They also said that the standard treatment controlled the lymphoma better than the lower dose treatment for people with follicular lymphoma and marginal zone lymphoma. As the lower dose also worked and may have fewer side effects, it may be useful for some people for controlling symptoms of their lymphoma.  

We have based this summary on information from the team who ran the trial. The information they sent us has been reviewed by independent specialists (peer reviewed Open a glossary item) and published in a medical journal. The figures we quote above were provided by the trial team. We have not analysed the data ourselves.

Recruitment start:

Recruitment end:

How to join a clinical trial

Please note: In order to join a trial you will need to discuss it with your doctor, unless otherwise specified.

Please note - unless we state otherwise in the summary, you need to talk to your doctor about joining a trial.

Chief Investigator

Professor P J Hoskin

Supported by

Cancer Research UK
Experimental Cancer Medicine Centre (ECMC)
Haematology Trials Group
National Institute for Health Research Cancer Research Network (NCRN)
University College London (UCL)

Other information

This is Cancer Research UK trial number CRUK/05/015.

Questions about cancer? Contact our information nurses

Freephone 0808 800 4040

Last review date

CRUK internal database number:

Oracle 596

Please note - unless we state otherwise in the summary, you need to talk to your doctor about joining a trial.

Around 1 in 5 people take part in clinical trials

3 phases of trials

Around 1 in 5 people diagnosed with cancer in the UK take part in a clinical trial.

Last reviewed:

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