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Brief Chemotherapy and Involved Field Radiation Therapy for Limited-Stage, Histologically Aggressive Lymphoma

JOSEPH M. CONNORS, M.D.; PAUL KLIMO, M.D.; RANDALL N. FAIREY, M.D.; and NICHOLAS VOSS, M.D.
[+] Article and Author Information

Grant support: Support of data analysis was supplied in part by a grant from Adria Laboratories of Canada, Incorporated.

Presented in part at the American Society of Clinical Oncology Meeting, May 1985, Houston, Texas.

▸Requests for reprints should be addressed to Joseph M. Connors, M.D.; Cancer Control Agency of B.C., 600 West 10th Avenue; Vancouver, BC, V5Z 4E6.


Vancouver, British Columbia,Canada


©1987 American College of PhysiciansAmerican College of Physicians


Ann Intern Med. 1987;107(1):25-30. doi:10.7326/0003-4819-107-1-25
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Study Objective: To determine the efficacy and toxicity of brief chemotherapy and involved field radiation therapy for treatment of limited-stage, histologically aggressive malignant lymphoma.

Design: Single-arm prospective trial.

Setting: Comprehensive cancer treatment center serving the entire population of British Columbia.

Patients: Consecutive enrollment of 78 patients ranging in age from 21 to 82 years (median, 64) with limited-stage (no B symptoms, Ann Arbor stage I or II, tumors less than 10 cm in diameter), diffuse large cell, mixed or immunoblastic histologic characteristics of malignant lymphoma seen at our institution between May 1980 and December 1984. All eligible patients were evaluated for response and relapse-free and overall survival.

Interventions: Chemotherapy with CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone) for three cycles followed by involved field radiation therapy to the original site of disease in a dose equivalent to 3000 cGy in ten fractions.

Main Results: The complete response rate was 99% (77 of 78 patients). With a median follow-up off treatment of 30 months the actuarial relapse-free survival is 84% and the overall survival is 85%. No deaths due to toxicity occurred.

Conclusions: Brief chemotherapy and involved field radiation therapy is highly successful treatment for patients with limited-stage, histologically aggressive malignant lymphoma. Toxicity of this approach is acceptable, even in the elderly. Staging laparotomy is not needed to select these patients. Future trials should incorporate more effective Chemotherapy programs.

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