THE TREATMENT OF ADVANCED STAGE FAVORABLE HISTOLOGY NON-HODGKINS LYMPHOMA - A PRELIMINARY-REPORT OF A RANDOMIZED TRIAL COMPARING SINGLE AGENT CHEMOTHERAPY, COMBINATION CHEMOTHERAPY, AND WHOLE-BODY IRRADIATION

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  • 1 January 1981
    • journal article
    • research article
    • Vol. 58  (3) , 592-598
Abstract
Between 1975-1978, 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 aklylating 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 now 41 mo. Actuarial survival is excellent, 84% at 4 yr for the entire group, with similar survival observed for each of the 3 treatment options. Initial complete remission rates (64%, 88% and 71%) were not significantly different in the 3 treatment arms. Frequent relapse after initial remission induction was noted with a freedom from relapse at 4 yr of only 25%. The toxicities of the 3 therapies were acceptable. Acute complications of therapy were most numerous in the group of patients treated with CVP. 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.