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

R. Freilone, B. Botto, U. Vitolo, M. Bertini, E. Audisio, R. Calvi, M. Cucchi, A. De Crescenzo, A. Gallamini, R. Ghio, L. Griso, A. Levis, G. Massara, L. Orsucci, U. Ricardi, D. Rota Scalabrini, F. Salvi, V. Seconde, L. Resegotti

Research output: Contribution to journalArticlepeer-review

Abstract

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. All 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 than 65 years; 52 patients had stage 1 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 survival 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 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 likehood of CNS relapse.

Original languageEnglish
Pages (from-to)919-924
Number of pages6
JournalAnnals of Oncology
Volume7
Issue number9
Publication statusPublished - Nov 1996

Keywords

  • chemotherapy plus radiotherapy
  • intermediate- to high-grade NHL
  • localized

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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