Abstract
Sixty previously untreated patients with high grade non-Hodgkin's lymphomas stages II-IV received cyclophosphamide 750 mg m2 i.v., doxorubicin 50 mg m2 i.v., and vincristine 2 mg i.v. on day 1, prednisolone 100 mg p.o. on days 1-5 and etoposide 100 mg m2 i.v. on days 3-5 (CHOP-VP16). After four courses an involved field irradiation with a total dose of 25 Gy was employed and followed by two additional courses of CHOP-VP16. The overall response rate was 93%, with 49 patients (82%) achieving a complete remission (CR). Seven patients had a partial response and four patients showed no response. During a median follow-up period of 55 months, 22 of the 49 patients with CR relapsed, seven of them achieving a second complete remission with the same drug regimen. A maintained complete remission of up to 68 months was seen in 55% of all patients initially achieving CR. The median survival is 43 months. Mean side-effects of this drug regimen were alopecia (89%), nausea/vomiting (76%) and leukopenia (61%). No therapy-related deaths were seen. The results of this study demonstrate that this combined modality treatment produces high complete remission rates and that more than half of these patients achieve long-term disease-free survival.
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- Aisner J., Van Echo D. A., Whitacre M., Wiernik P. H. A phase I trial of continuous infusion VP16-213 (etoposide). Cancer Chemother Pharmacol. 1982;7(2-3):157–160. doi: 10.1007/BF00254539. [DOI] [PubMed] [Google Scholar]
- Brittinger G., Meusers P., Engelhard M. Strategien der Behandlung von Non-Hodgkin-Lymphomen. Internist (Berl) 1986 Aug;27(8):485–497. [PubMed] [Google Scholar]
- Cabanillas F., Burgess M. A., Bodey G. P., Freireich E. J. Sequential chemotherapy and late intensification for malignant lymphomas of aggressive histologic type. Am J Med. 1983 Mar;74(3):382–388. doi: 10.1016/0002-9343(83)90955-5. [DOI] [PubMed] [Google Scholar]
- Canellos G. P., Skarin A. T., Rosenthal D. S., Moloney W. C., Frei E., 3rd Methotrexate as a single agent and in combination chemotherapy for the treatment of non-Hodgkin's lymphoma of unfavorable histology. Cancer Treat Rep. 1981;65 (Suppl 1):125–129. [PubMed] [Google Scholar]
- Coiffier B., Bryon P. A., Berger F., Archimbaud E., Ffrench M., Extra J. M., Guyotat D., Fiere D., Gentilhomme O., Magaud J. P. Intensive and sequential combination chemotherapy for aggressive malignant lymphomas (protocol LNH-80). J Clin Oncol. 1986 Feb;4(2):147–153. doi: 10.1200/JCO.1986.4.2.147. [DOI] [PubMed] [Google Scholar]
- Coleman C. N., Picozzi V. J., Jr, Cox R. S., McWhirter K., Weiss L. M., Cohen J. R., Yu K. P., Rosenberg S. A. Treatment of lymphoblastic lymphoma in adults. J Clin Oncol. 1986 Nov;4(11):1628–1637. doi: 10.1200/JCO.1986.4.11.1628. [DOI] [PubMed] [Google Scholar]
- Fisher R. I., DeVita V. T., Jr, Hubbard S. M., Longo D. L., Wesley R., Chabner B. A., Young R. C. Diffuse aggressive lymphomas: increased survival after alternating flexible sequences of proMACE and MOPP chemotherapy. Ann Intern Med. 1983 Mar;98(3):304–309. doi: 10.7326/0003-4819-98-3-304. [DOI] [PubMed] [Google Scholar]
- Hoppe R. T. The role of radiation therapy in the management of the non-Hodgkin's lymphomas. Cancer. 1985 May 1;55(9 Suppl):2176–2183. doi: 10.1002/1097-0142(19850501)55:9+<2176::aid-cncr2820551421>3.0.co;2-l. [DOI] [PubMed] [Google Scholar]
- Klimo P., Connors J. M. MACOP-B chemotherapy for the treatment of diffuse large-cell lymphoma. Ann Intern Med. 1985 May;102(5):596–602. doi: 10.7326/0003-4819-102-5-596. [DOI] [PubMed] [Google Scholar]
- Laurence J., Coleman M., Allen S. L., Silver R. T., Pasmantier M. Combination chemotherapy of advanced diffuse histiocytic lymphoma with the six-drug COP-BLAM regimen. Ann Intern Med. 1982 Aug;97(2):190–195. doi: 10.7326/0003-4819-97-2-190. [DOI] [PubMed] [Google Scholar]
- McKelvey E. M., Gottlieb J. A., Wilson H. E., Haut A., Talley R. W., Stephens R., Lane M., Gamble J. F., Jones S. E., Grozea P. N. Hydroxyldaunomycin (Adriamycin) combination chemotherapy in malignant lymphoma. Cancer. 1976 Oct;38(4):1484–1493. doi: 10.1002/1097-0142(197610)38:4<1484::aid-cncr2820380407>3.0.co;2-i. [DOI] [PubMed] [Google Scholar]
- Monfardini S., Banfi A., Bonadonna G., Rilke F., Milani F., Valagussa P., Lattuada A. Improved five year survival after combined radiotherapy-chemotherapy for stage I-II non-Hodgkin's lymphoma. Int J Radiat Oncol Biol Phys. 1980 Feb;6(2):125–134. doi: 10.1016/0360-3016(80)90027-9. [DOI] [PubMed] [Google Scholar]