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The treatment of advanced stage favorable histology non-Hodgkin's lymphoma:
a preliminary report of a randomized trial comparing single agent
chemotherapy, combination chemotherapy, and whole body irradiation
RT Hoppe, P Kushlan, HS Kaplan, SA Rosenberg and BW Brown
Between 1975 and 1978, 51 patients with favorable histology non- Hodgkin's
lymphomas, pathologic stage III-IV, were treated prospectively on a
randomized treatment protocol. Treatment options were single alkylating
agent chemotherapy, combination chemotherapy with cyclophosphamide,
vincristine, and prednisone (CVP), or fractionated whole body irradiation
followed by low dose involved field irradiation. The median follow-up
interval in this group of patients is not 41 mo. Actuarial survival is
excellent, 84% at 4 yr for the entire group, with similar survival observed
for each of the three treatment options. Initial complete remission rates
(64%, 88%, and 71%) were not significantly different in the three treatment
arms. Frequent relapse after initial remission induction was noted,
however, with a freedom from relapse at 4 yr of only 25%. The toxicities of
the three therapies were acceptable. Acute complications of therapy were
most numerous in the group of patients treated with CVP; however, long-term
hematologic depression was most commonly observed in patients treated with
whole body irradiation. In general, hematologic complications were more
frequent among patients who had marrow involvement and intact spleens at
the time of initial therapy. The relationship of this study to other
clinical trials in the management of patients with advanced stage favorable
histology lymphomas and its implications for future clinical trials are
discussed.
Volume 58,
Issue 3,
pp. 592-598,
09/01/1981
Copyright © 1981 by The American Society of Hematology
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