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

Freilone, Roberto; Botto, Barbara; Vitolo, Umberto; Bertini, M; Audisio, Ernesta; Calvi, R; Cucchi, M.C.; Crescenzo, Alberto De; Gallamini, Andrea; Ghio, Riccardo; Griso, Luciano; Levis, Alessandro; Massara, G; Orsucci, Lorella; Ricardi, Umberto; Scalabrini, Delia Rota; Salvi, Flavia; Secondo, V.; Resegotti, L

doi:10.1093/oxfordjournals.annonc.a010794

Cited by 11 publications

(6 citation statements)

References 26 publications

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“…Our results show a 6-year survival probability of 94.5% for stage I patients and 82.8% for stage II (P = 0.2). These results correlate well with previously published data reporting a similar complete remission, survival and disease-free survival probability using third generation regimens (13,14), with very low treatmentrelated toxicity.…”

Section: Discussionsupporting

confidence: 92%

“…When compared to standard CHOP therapy, intensive second and third generation regimens seem to offer no advantage when used as front-line therapy in advanced diffuse and aggressive NHL (6,11,12). However, there are few reports of second or third generation regimens alone or combined with radiotherapy as front-line treatment for localized NHL (13,14).…”

Section: Introductionmentioning

confidence: 99%

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A third generation regimen VACOP-B with or without adjuvant radiotherapy for aggressive localized non-Hodgkin's lymphoma: report from the Italian Non-Hodgkin's Lymphoma Co-operative Study Group

Santini¹,

Souza

Aversa³

et al. 2004

Braz J Med Biol Res

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The objective of this multicenter prospective study was to determine the clinical efficacy and toxicity of a polychemotherapeutic third generation regimen, VACOP-B, with or without radiotherapy as frontline therapy in aggressive localized non-Hodgkin's lymphoma. Ninetythree adult patients (47 males and 46 females, median age 45 years) with aggressive localized non-Hodgkin's lymphoma, 43 in stage I and 50 in stage II (non-bulky), were included in the study. Stage I patients received VACOP-B for 6 weeks plus involved field radiotherapy and stage II patients received 12 weeks VACOP-B plus involved field radiotherapy on residual masses. Eighty-six (92.5%) achieved complete remission and 4 (4.3%) partial remission. Three patients (3.2%) were primarily resistant. Ten-year probability of survival, progression-free survival and disease-free survival were 87.3, 79.9 and 83.9%, respectively. Eighty-four patients are surviving at a median observation time of 57 months (range: 6-126). Statistical analysis showed no difference between stages I and II in terms of response, ten-year probability of survival, progression-free survival or disease-free survival. Side effects and toxicity were negligible and were similar in the two patient groups. The results of this prospective study suggest that 6 weeks of VACOP-B treatment plus radiotherapy may be the therapy of choice in stage I aggressive non-Hodgkin's lymphoma. Twelve weeks of VACOP-B treatment with or without radiotherapy was shown to be effective and feasible for stage II. These observations need to be confirmed by a phase III study comparing first and third generation protocols in stage I-II aggressive non-Hodgkin's lymphoma.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

A third generation regimen VACOP-B with or without adjuvant radiotherapy for aggressive localized non-Hodgkin's lymphoma: report from the Italian Non-Hodgkin's Lymphoma Co-operative Study Group

Santini¹,

Souza

Aversa³

et al. 2004

Braz J Med Biol Res

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“…In a French prospective study with alternating chemotherapy and radiotherapy in stage I Á/II the 5-year disease-free survival was 77% for patients in stage I and 67% in stage II (25). In an Italian co-operative study with a 6-week chemotherapy regimen followed by locoregional radiotherapy (36 Gy), the 4-year relapse-free survival for stages I and II was 80% and 78%, respectively (26).…”

Section: Aggressive Non-hodgkin's Lymphomasmentioning

confidence: 99%

A Systematic Overview of Radiation Therapy Effects in Non-Hodgkin's Lymphoma

2003

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“…However, chemotherapy programs were different depending on the stage of disease, time of diagnosis and prognostic factors. Eleven patients with localized stage of disease without adverse prognostic features were treated with brief chemotherapy, ACOPB (adriamycin, cyclophosphamide, vincristine, prednisone, bleomycin) 27 or three courses of CHOP (cyclophosphamide, adriamycin, vincristine, prednisone), 28 followed by locoregional radiotherapy at a dose of 36 Gy. Fifty-five patients with advanced Leukemia stage or localized stage with adverse prognostic features were treated with CHOP regimens (41 patients) or a third generation chemotherapy scheme such as MACOPB (methotrexate, adriamycin, cyclophosphamide, vincristine, prednisone, bleomycin) (seven patients) 29 or VACOPB (etoposide, adriamycin, cyclophosphamide, vincristine, prednisone, bleomycin) (seven patients).…”

Section: Treatmentmentioning

confidence: 99%

Point mutations of the BCL-6 gene: clinical and prognostic correlation in B-diffuse large cell lymphoma

et al. 2002

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Although point mutations of the 5′ noncoding regions of the BCL-6 proto-oncogene are frequently detected in B-diffuse large cell lymphoma (B-DLCL), a thorough analysis of the clinical correlation of these mutations has not been performed to date. In this study, BCL-6 mutations were examined by DNA direct sequencing in 103 patients with B-DLCL. BCL-6 mutations were found in 53/103 patients, including 38/76 treated with standard chemotherapy and 15/27 treated with autologous stem cell transplantation (ASCT) up front. The presence of BCL-6 mutations was correlated with clinical features at diagnosis and outcome. Mutated patients had a significantly higher LDH level (66% vs 38%, P Ͻ 0.05), and bulky disease (51% vs 32%, P = 0.05). In the whole series of patients BCL-6 mutations did not affect CR and OS. Patients with BCL-6 mutations tended to have a prolonged 5-years DFS and FFS compared to those without mutations (DFS 82% vs 63%, FFS 63% vs 49%). Among B-DLCL treated with standard chemotherapy, mutated patients showed a significantly improved 5-year DFS (85% vs 61%, P Ͻ 0.05) and, notably, the only four relapses observed among mutated patients occurred in less than 8 months. The multivariate regression analysis (P Ͻ 0.01) with DFS as endpoint confirmed the independent prognostic value of BCL-6 mutations. There was a trend for 5-year failurefree survival to be better for patients with BCL-6 mutations (63% vs 43%, P = 0.09). In the 27 patients treated with ASCT, BCL-6 mutations did not correlate with outcome. These results suggest that BCL-6 mutations may predict a higher chance of being free of disease in B-DLCL treated with standard chemotherapy. Larger series of patients need to be analyzed to evaluate the clinical relevance of BCL-6 mutations properly. Leukemia (2002) 16, 268-275.

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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

Abstract: This combined program is effective and probably curative in localized stage intermediate- to high-grade NHL, with low toxicity, also in elderly people. Patients with NHL of the testis, as primary site, require CNS prophylaxis due to the high likelihood of CNS relapse.

Cited by 11 publications

References 26 publications

A third generation regimen VACOP-B with or without adjuvant radiotherapy for aggressive localized non-Hodgkin's lymphoma: report from the Italian Non-Hodgkin's Lymphoma Co-operative Study Group

A third generation regimen VACOP-B with or without adjuvant radiotherapy for aggressive localized non-Hodgkin's lymphoma: report from the Italian Non-Hodgkin's Lymphoma Co-operative Study Group

A Systematic Overview of Radiation Therapy Effects in Non-Hodgkin's Lymphoma

Point mutations of the BCL-6 gene: clinical and prognostic correlation in B-diffuse large cell lymphoma

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