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 language||English (US)|
|Issue number||11 PART II|
|State||Published - Dec 1 2000|
ASJC Scopus subject areas
- Cell Biology