Combined modality therapy for stage i-ii large cell lymphoma

Prestidge, Bradley R.; Horning, Sandra J.; Hoppe, Richard T.

doi:10.1016/0360-3016(88)90305-7

Cited by 35 publications

(7 citation statements)

References 20 publications

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“…The freedom-fromrelapse curves appear to flatten after 6 years, suggesting a cure. The results for intermediate/highgrade lymphoma (10-year absolute survival, 41% with RT alone and 57% with CMT) are similar to other results in the literature, 1,[16][17][18][19][20][21][22] and relapsefree survival curves also flatten after 5-6 years, suggesting cure. The results were not analyzed by the International Prognostic Index because all of the patients had stage I or II disease and most patients' LDH levels were unknown.…”

Section: Discussionsupporting

confidence: 88%

Non-Hodgkin's lymphoma of the head and neck: A 30-year experience at the university of Florida

et al. 1999

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Section: Discussionsupporting

confidence: 88%

Non-Hodgkin's lymphoma of the head and neck: A 30-year experience at the university of Florida

et al. 1999

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“…Bulky disease has been identified as an adverse prognostic factor in some series (Kaminski et al, 1986;Hagberg et al, 1989;Horwich et al, 1988;Mackintosh et al, 1988;Prestidge et al, 1988;Shigematsu et al, 1988), but not others (Kantarjian et al, 1984;Jones et al, 1989;Taylor et al, 1988). We selected >5 cm after surgical biopsy as representing bulky disease and chose to treat those patients with combination chemotherapy, utilising radiotherapy for non-bulky cases.…”

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confidence: 99%

Involved field radiotherapy or chemotherapy in the management of stage I nodal intermediate grade non-Hodgkin's lymphoma

Jeffery

Mead²,

Whitehouse³

et al. 1991

Br J Cancer

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Early stage intermediate grade non-Hodgkin's lymphoma (NHL) is frequently treated with chemotherapy alone or in conjunction with radiotherapy. We have managed clinical Stage I nodal, intermediate grade NHL with involved field radiotherapy alone for non-bulky (less than 5 cm post-surgery) disease or combination chemotherapy alone for more bulky disease. Forty-three patients were treated between 1978 and 1989. Of the 30 patients with non-bulky disease treated with radiotherapy, 29 (97%) achieved complete remission (CR). Thirteen (42%) patients relapsed after radiotherapy and ten of these achieved a further CR (durable in eight) following salvage chemotherapy. Eleven patients with bulky disease received combination chemotherapy with nine (82%) attaining CR (durable in eight). Two patients with bulky disease received radiotherapy-both achieved CR, but have relapsed and died of lymphoma. Overall actuarial 5 year survival for the total group is 77% with a median follow-up of 30 months (range 3-119 months). The 5 year actuarial survival for the 30 patients with non-bulky disease treated with radiotherapy is 86% at a median follow-up of 39 months (range 8-119 months). The 4 year actuarial survival of the 11 patients treated with chemotherapy is 60% with a median follow-up of 25 months (range 3-55 months). We conclude that involved field radiotherapy alone is efficacious for clinical stage I patients with non-bulky nodal intermediate grade NHL and that patients relapsing after radiotherapy are adequately salvaged by chemotherapy. Patients with bulky disease have an inferior survival and should receive combination chemotherapy.

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“…Although it has been reported that 5-year, relapse-free and total survival rates were significantly improved in patients with diffuse histologies treated with cyclophosphamide, vincristine, and prednisone (CVP therapy) compared with patients managed with regional irradiation alone [30], chemotherapy without adriamycin did not influence the prognosis in our series. Recent reports have emphasized that drug combinations for large-cell lymphoma should include adriamycin [6,7,9,31]. Chemotherapy without adriamycin is no longer considered to be an adequate regimen for the control of most lymphomas, with the possible exception of Stage I disease [6].…”

Section: Discussionmentioning

confidence: 99%

Treatment of localized non-hodgkin's lymphomas of the head and neck: Focusing on cases of non-lethal midline granuloma

Sakata

Hareyama

Oouchi

et al. 1998

Radiat. Oncol. Investig.

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This report clarifies the prognostic factors for survival in localized non‐Hodgkin's lymphoma (NHL) of the head and neck and defines optimal regimens for this disease. One hundred‐seven untreated patients with Stage I or II NHL of the head and neck were treated with involved field radiation therapy for orbital, nasal, or paranasal lymphoma and extended field radiation for Waldeyer's ring or neck lymphoma. Radiation doses were 39–48 Gy. In the latter half of the study, adjuvant chemotherapy was administered. Of 107 patients, 95 achieved complete response (CR). Of the 12 patients that did not achieve CR, 9 had nasal T‐cell lymphoma (NTL) of the lethal midline granuloma type (LMG‐NTL). Only one patient who obtained CR relapsed in a previously irradiated area. Age, sex, stage, bulky mass, number of involved sites, LMG‐NTL, histologic subtypes, radiation dose, and adriamycin dose were analyzed for prognostic significance for disease‐specific survival in NHL by multivariate analysis. LMG‐NTL was the most significant prognostic factor (P < 0.001). Patients with higher age also experienced a higher relative risk than patients of ⩾60 years of age (P = 0.0063). Dose of adriamycin reached the borderline significance (P = 0.0600). Radiotherapy is excellent for obtaining local control of head and neck NHL. Randomized trials are required to determine the appropriate radiation field and dose in patients previously treated with chemotherapy. LMG‐NTL and age were the significant prognostic factors for disease‐specific survival. Radiat. Oncol. Invest. 6:161–169, 1998. © 1998 Wiley‐Liss, Inc.

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Combined modality therapy for stage i-ii large cell lymphoma

Cited by 35 publications

References 20 publications

Non-Hodgkin's lymphoma of the head and neck: A 30-year experience at the university of Florida

Non-Hodgkin's lymphoma of the head and neck: A 30-year experience at the university of Florida

Involved field radiotherapy or chemotherapy in the management of stage I nodal intermediate grade non-Hodgkin's lymphoma

Treatment of localized non-hodgkin's lymphomas of the head and neck: Focusing on cases of non-lethal midline granuloma

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