CHEMOTHERAPY (CYCLOPHOSPHAMIDE, VINCRISTINE, AND PREDNISONE) VERSUS RADIOTHERAPY (TOTAL-BODY IRRADIATION) FOR STAGE-III-IV POORLY DIFFERENTIATED LYMPHOCYTIC LYMPHOMA

  • 1 January 1978
    • journal article
    • research article
    • Vol. 62  (3) , 321-325
Abstract
Patients (72) with stage III-IV malignant lymphoma of the poorly differentiated lymphocytic (PDL) type were randomly assigned to initial chemotherapy with cyclophosphamide, vincristine and prednisone (CVP) or to radiotherapy with total body irradiation (TBI). The response and survival rates were similar for CVP and TBI in patients with nodular PDL, with 66% and 67%, respectively, surviving at 7 yr. Induction treatment with TBI yielded better response and earlier survival than CVP for patients with diffuse PDL but a survival advantage did not exist at 5 yr, the survival rate being 28% and 25%, respectively. TBI was more easily tolerated than CVP as initial therapy; 19(51%) of the 37. CVP patients had a complication which required hospitalization during the first 6 cycles as contrasted to only 1 of 35 patients receiving TBI who required hospitalization. Most chemotherapy complications were infectious in nature, secondary to relatively severe granulocytopenia, and 1 patient died from Candida sepsis following the 1st cycle of CVP. Late complications consisted of 2 TBI patients who developed a myeloproliferative disorder and 2 CVP patients who experienced persistent disabling neurotoxic reactions. Durable remissions were not achieved with significant frequency using either form of treatment, indicating a need to evaluate new therapeutic approaches for the management of PDL lymphoma.