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J Korean Cancer Assoc > Volume 30(4); 1998 > Article
Journal of the Korean Cancer Association 1998;30(4): 809-817.
Primary CHOP Chemotherapy Followed by Involved Field Radiation Therapy in Clinical Stage I or II Aggressive Non-Hodgkin's Lymphomas
Chang Hee Lee, Young Hyuck Im, Baek Yeol Ryoo, Seung Mo Nam, Mi Sook Kim, Yong Sik Lee, Kyung Kyun Oh, Yoon Sang Shim, Seong Yul Yoo, Jhin Oh Lee, Tae Woong Kang, Yoon Koo Kang
1Departments of Internal Medicine, Korea Cancer Center Hospital, Seoul, Korea.
2Departments of Otolaryngology-Head and Neck Surgery, Korea Cancer Center Hospital, Seoul, Korea.
3Departments of Radiation Oncology, Korea Cancer Center Hospital, Seoul, Korea.
Although radiation therapy had been the treatment of choice for localized non-Hodgkin's lymphoma(NHL), recent studies have revealed that treatment result after radiation therapy alone is not successful for localized aggressive NHL, if it is not pathologically but clinically staged. A prospective phase II trial was conducted to evaluate the therapeutic results of 4 cycles of CHOP chemotherapy followed by involved field radiation therapy in clinically staged localized aggressive NHL.
Patients with a diagnosis of aggressive NHL(all intermediate grade and immunoblastic histology in NCI working formulation), Ann Arbor stage I or II without poor prognostic factors(presence of B symptoms, bulky diseases, or 2 or more extranodal involvement) were treated with 4 cycles of CHOP(cyclophosphamide, doxorubicin, vincristine, prednisolone) followed by involved field radiation therapy of 3,000~6,000(median: 4,500) cGy.
Between April 1990 and March 1995, 62 consecutive patients entered this trial. Forty six patients with measurable diseases were evaluable for response. Complete response was achieved in 41(89.1%) patients after CHOP chemotherapy and 4 more patients after subsequent radiation therapy, making total CR rate of 98%. Progression free survival(PFS) of all 62 patients were 2.2+~73+ months and 5 year PFS rate was 64.6%. Overall survival(OS) were 2.4+~75+ months and 5 year OS rate was 75.2%. Old age (> 60) was the only significant prognostic factor, which-affected overall survival negatively. Treatment was relatively well tolerated, but 3 patients died associated with treatment.
Four cycles of CHOP chemotherapy followed by involved field radiation therapy is highly curative and safe treatment for clinically staged, localized aggressive NHLs.
Key words: Localized aggressive non-Hodgkins lymphoma;CHOP chemotherapy;Involved field radiation therapy
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