Radiation therapy's contribution to local control and progression-free survival in patients with aggressive lymphomas

Richard B. Wilder, Maria A. Rodriguez, Susan L. Tucker, Chul S. Ha, Mark A. Hess, Fernando F. Cabanillas, James D. Cox

Research output: Contribution to journalArticle

Abstract

Purpose: To analyze the results with cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP)-based chemotherapy with or without involved-field radiotherapy in patients with aggressive lymphomas. Methods: From September 1988 through December 1996, 294 previously-untreated, favorable patients with Working Formulation intermediate grade or large-cell immunoblastic lymphomas underwent 5 ±1 (mean ±standard deviation) cycles of CHOP-based chemotherapy on two protocols at the M. D. Anderson Cancer Center. Two hundred and nineteen of these patients underwent involved-field radiotherapy after at least a partial response had been achieved to the chemotherapy. The decision regarding whether to administer radiotherapy was left to the discretion of the treating physician. The Fisher's exact test, Kaplan-Meier analysis, and log-rank test were used, as appropriate. Results: Median follow-up was 61 months. The progressive or stable disease, partial response, unconfirmed complete response and complete response rates to chemotherapy were 3%. 9%, 6% and 82%, respectively. Patients with progressive or stable disease had a median survival of 9.5 months. Among partial and unconfirmed complete responders to chemotherapy, local control (5-year rates: 86% vs 53%, p = 0.009) and progression-free survival (5-year rates: 61% vs 8%, p < 0.0001) but not overall survival (5-year rates: 70% vs 50%. p = 0.067) were significantly better in those who received involved-field radiotherapy. Among complete responders, patients who presented with larger lymphomas were typically referred for radiotherapy. Nevertheless, local control (5-year rates: 97% vs 81%, p = 0.0007) was better in those who received radiotherapy. Conclusion: The role of involved-field radiotherapy in partial and unconfirmed complete responders to CHOP chemotherapy justifies examination in a large, cooperative group trial.

Original languageEnglish (US)
Pages (from-to)251b
JournalBlood
Volume96
Issue number11 PART II
StatePublished - Dec 1 2000

ASJC Scopus subject areas

  • Biochemistry
  • Immunology
  • Hematology
  • Cell Biology

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  • Cite this

    Wilder, R. B., Rodriguez, M. A., Tucker, S. L., Ha, C. S., Hess, M. A., Cabanillas, F. F., & Cox, J. D. (2000). Radiation therapy's contribution to local control and progression-free survival in patients with aggressive lymphomas. Blood, 96(11 PART II), 251b.