85910
document
Adjuvant cyclophosphamide , doxorubicin , vincristine , and prednisone chemotherapy after radiation therapy in stage I low-grade and intermediate-grade non-Hodgkin lymphoma . Results of a prospective randomized study . BACKGROUND In a prospective randomized manner , this study evaluated the effect of adjuvant chemotherapy ( cyclophosphamide , doxorubicin , vincristine , and prednisone ; CHOP ) in patients with Stage I non-Hodgkin lymphoma ( NHL ) who have achieved a complete response ( CR ) after radiation therapy ( RT ) . METHODS Forty-four patients with clinical or pathologic Stage I intermediate-grade or low-grade NHL were randomized to receive regional RT alone ( median dose , 40 Gy ) or regional RT followed by six cycles of CHOP chemotherapy . There were no differences in clinical and pathologic characteristics between the two treatment groups . RESULTS The median follow-up was 7 years ( range , 2-10 years ) . The actuarial relapse-free survival ( RFS ) rate for the RT plus CHOP group at 7 years was 83 % compared with 47 % ( P < 0.03 ) for the RT-alone group . The overall survival ( OS ) for the two groups was 88 % and 66 % , respectively ( P = 0.2 ) . In patients with intermediate-grade NHL , the 7-year actuarial RFS for RT and CHOP was 86 % compared with 20 % for RT alone ( P = 0.004 ) . The corresponding actuarial survival rates were 92 % and 47 % , respectively ( P = 0.08 ) . In patients with low-grade histologic findings , the addition of adjuvant CHOP did not improve RFS ( P = 0.6 ) or OS . All relapses in this study were at sites remote from the initially involved areas , and in 5 of 11 patients ( 45 % ) , there were recurrences 5 years or longer after initial treatment . CONCLUSIONS This study showed that adjuvant CHOP chemotherapy significantly improves RFS in patients with Stage I intermediate-grade NHL who achieve a CR after regional-field RT . The chemotherapeutic regimen favorably affected their probability of survival .
85911
Intervention_Pharmacological
cyclophosphamide
85912
Intervention_Pharmacological
doxorubicin
85913
Intervention_Pharmacological
vincristine
85914
Intervention_Physical
prednisone chemotherapy
85915
Intervention_Pharmacological
adjuvant chemotherapy
85916
Intervention_Pharmacological
cyclophosphamide
85917
Intervention_Pharmacological
doxorubicin
85918
Intervention_Pharmacological
vincristine
85919
Intervention_Pharmacological
prednisone
85920
Intervention_Pharmacological
CHOP
85921
Intervention_Control
receive regional RT alone ( median dose , 40 Gy )
85922
Intervention_Physical
regional RT followed by six cycles of CHOP chemotherapy
85923
Intervention_Physical
CHOP
85924
Intervention_Physical
CHOP chemotherapy
85925
Outcome_Other
median follow-up
85926
Outcome_Mortality
actuarial relapse-free survival ( RFS ) rate
85927
Outcome_Mortality
overall survival ( OS )
85928
Outcome_Mortality
7-year actuarial RFS
85929
Outcome_Mortality
corresponding actuarial survival rates
85930
Outcome_Mortality
RFS
85931
Outcome_Other
probability
85932
Outcome_Mortality
survival .
85933
Participant_Condition
stage I low-grade and intermediate-grade non-Hodgkin lymphoma .
85934
Participant_Condition
patients with Stage I non-Hodgkin lymphoma ( NHL ) who have achieved a complete response ( CR ) after radiation therapy ( RT ) .