Prospective multicenter trial for the response-adapted treatment of high-grade malignant non-Hodgkin's lymphomas: Updated results of the COP-BLAM/IMVP-16 protocol with randomized adjuvant radiotherapy

Autor: Thomas Zwingers, H. J. Staiger, H. Radtke, E. Terhardt, W. Gassmann, P. Meusers, Eva Lengfelder, Hubert J. Stein, H. H. Gerhartz, T. Wagner, C. Schöber, F. Ludwig, Karl Lennert, M. G. Willems, Michael Hallek, W. Dornoff, W. Hettchen, Eckhard Thiel, Wolfgang Siegert, I. Meuthen, W. Enne, Markus Tiemann, M. Thomas, R. Kuse, J. Heise, Dieter Huhn, C. Schadeck, N. Brack, Wolfgang Wilmanns, K. Kabelitz, M. Engelhard, Günter Brittinger, E. Schumacher
Rok vydání: 1991
Předmět:
Zdroj: Annals of Oncology. 2:177-180
ISSN: 0923-7534
Popis: In a prospective multicenter trial the efficiency of the response-adapted COP-BLAM/IMVP-16 protocol to induce complete remissions (CR) in high-grade malignant non-Hodgkin’s lymphomas as well as the prognostic relevance of adjuvant radiotherapy were investigated. From 1986–1989, 548 patients (median age 56 years) with stage II–IV (Ann Arbor) disease were treated with five cycles of COP-BEAM followed by two cycles of IMVP-16. If only a partial remission was obtained at the time of first restaging (RS) after three cycles (delayed response), treatment was switched to IMVP-16 (two to five courses) immediately. Patients achieving CR by the second RS after chemotherapy were randomized to adjuvant radiotherapy or observation. Responses to chemotherapy were 63% CR in patients completing the second RS (N = 350) or 72% if patients achieving late CR by consolidating radiotherapy are added; responses were 58% or 65% if all deaths prior to the second RS are included (N = 50). Overall and relapse-free survival were 71% and 68% at one year and 63% and 61% at two years. Multivariate risk factor analysis proved the early (by first RS) CR response to possess predominant prognostic relevance for survival. A significant advantage of adjuvant radiotherapy over no further treatment for duration of CR is not yet discernible. These results emphasize the importance of a rapidly achieved CR, thus contributing to the design of future trials.
Databáze: OpenAIRE