Combined modality treatment with a weekly brief chemotherapy (ACOP-B) followed by locoregional radiotherapy in localized-stage intermediate- to high-grade non-Hodgkin's lymphoma

Autor: R Calvi, Lorella Orsucci, Andrea Gallamini, D. Rota Scalabrini, L. Griso, A. Levis, Barbara Botto, Riccardo Ghio, M. Cucchi, Umberto Ricardi, V. Secondo, Umberto Vitolo, Roberto Freilone, Ernesta Audisio, A. De Crescenzo, Marilena Bertini, G. Massara, Luigi Resegotti, Flavia Salvi
Rok vydání: 1996
Předmět:
Zdroj: Scopus-Elsevier
ISSN: 0923-7534
Popis: Summary Background: >A cooperative study was undertaken to evaluate the efficacy and toxicity of a very brief course of chemotherapy followed by locoregional radiotherapy in patients with localized-stage intermediate- to high-grade non-Hodgkin's lymphoma (NHL). Patients and method: From January 1988 to November 1994, 84 patients with localized stages IA and IIA intermediate- to high-grade NHL underwent a combined modality treatment. AU patients underwent a six-week chemotherapy regimen, ACOP-B (doxorubicin 50 mg/sqm and cyclophosphamide 350 mg/sqm on weeks 1, 3, 5; vincristine 1.4 mg/sqm and bleomycin 10 mg/sqm on weeks 2, 4, 6; prednisone 50 mg p.o. daily throughout the first two weeks and thereafter every other day), followed by locoregional radiotherapy (36 Gy). Results: The median age was 58 years, with 35% older apthan 65 years; 52 patients had stage I and 32 stage II; 39 patients had extranodal ± nodal involvement, and 4 had testicular involvement. Treatment was well tolerated, with only 38% suffering from mild mucositis and no toxic deaths. Seventy-nine patients achieved CR after ACOP-B and 83 at the end of the program. With a median follow-up of four years, relapse-free survial was 79% with 15 relapses (93% disseminated). Two patients with testis lymphoma had CNS relapses. Overall survival was 90% at four years. Conclusion: This combined program is effective and probably curative in localized stage intermediate- to highgrade NHL, with low toxicity, also in elderly people. Patients with NHL of the testis, as primary site, require CNS prophylaxis due to the high likehood of CNS relapse.
Databáze: OpenAIRE