INITIAL CHEMOTHERAPY FOR CLINICALLY LOCALIZED LYMPHOMAS OF UNFAVORABLE HISTOLOGY

  • 1 January 1983
    • journal article
    • research article
    • Vol. 62  (2) , 413-418
Abstract
Patients (45) with localized non-Hodgkin''s lymphoma of unfavorable histologic type (41 patients had diffuse histiocytic, 2 had nodular mixed and 2 had minimally nodular histiocytic lymphoma) were treated with initial chemotherapy (28 patients) including cyclophosphamide, adriamycin, vincristine and prednisone (CHOP), or with initial CHOP followed by involved field radiotherapy (17 patients). Patients were clinically staged and found to have stage I (7 patients), stage IE (8), stage II (12) and stage IIE (18). Despite the presence of potentially adverse prognostic factors, including age > 65 yr (11 patients), bulky disease (17), gastrointestinal involvement (9) and B symptoms (4), 44 of 45 patients (98%) achieved a complete response. A total of 42 patients (93%) are alive with a median follow-up time of 41 mo. (range 3-128 mo.). A total of 38 patients (84%) remain continuously free of disease. Neither the pretreatment clinical features nor the type of treatment significantly influenced the outcome for patients treated with intial chemotherapy. Patients who failed treatment relapsed at distant sites or initially involved sites whether or not they received radiotherapy. Initial treatment for localized lymphomas of unfavorable histology with chemotherapy regimens of proven curative potential in advanced disease is a successful treatment strategy and obviates the need for extensive staging. The role of involved field radiotherapy following initial chemotherapy needs to be defined.