Vacop-B for stage I/II aggressive non-hodgkin's lymphoma: report from the nhlcsg

G. Santini, L. Salvagno, I. Majolino, T. Chisesi, M. Candela, A. Olivieri, L. Tedeschi, P. Vivaldi, T. Contu, P. Coser, V. Rizzoli, A. Rubagotti, L. Endrizzi, A. Porcellini, C. De Souza

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Abstract

The aim of this multicentre prospective study was to establish the role of a third generation regimen (VACOP-B) plus/minus radiotherapy (RT) as front-line therapy in patients (pts) with aggressive stage I-II non-Hodgkin's lymphoma(NHL). Between October 1991 and November 1999,70 pts, aged 15 to 60 years, with diffuse mixed and large cell-type (Working Formulation criteria) non bulky NHL, 28 in Stage 1 (40%) and 42 in Stage II (60%), were enrolled. Stage I pts received VACOP-B for 6 weeks followed by involved field (IF) RT. Stage 11 pts received VACOP-B for 12 weeks plus IF RT on residual masses. 67 pts (96%) presented objective response (CR, 65 pts=93%; PR, 2 pts=3%). No difference in terms of response rate was observed between stage I and II pts. One patient in stage 1 and 2 pts in stage II were primary resistant. Extra-haematological toxicity was very mild. Two pts in stage I and 8 pts in stage II relapsed. With a median follow-up observation time of 38 months, the 7-year overall survival (OS) probability is 89.7% (+-4.7%), with a PFS of 77.6% (+-5.9%) and a DPS of 81.8% (+-5.9%). Univariate analysis showed a trend in favour of Stage 1 in terms of OS (P=0.08). This prospective study suggests that a third generation regimen combined with RT, is effective in patients with stage I-II aggressive NHL. According to previous observations achieved with first generation regimens, 6 courses of VACOP-B plus RT seem to be the therapy of choice in Stage I patients. Moreover, 12 cycles of VACOP-B plus/minus RT seem to be effective in the majority of Stage IT pts. In conclusion, VACOP-B as front-line therapy, with or without RT, was an effective and feasible therapy in these pts, with very low treatment related toxicity. However, this observation must be confirmed with a phase III study.

Original languageEnglish
JournalBlood
Volume96
Issue number11 PART II
Publication statusPublished - 2000

ASJC Scopus subject areas

  • Hematology

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