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	Full Text PDF Editorial by Cosset, J.M. Letters Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited PubMed Citation

ABSTRACT

Background Patients with clinically localized, intermediate- or high-grade non-Hodgkin's lymphoma usually receive initial treatment with a doxorubicin-containing regimen such as cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP). Pilot studies suggest that eight cycles of CHOP alone or three cycles of CHOP followed by involved-field radiotherapy are effective in such patients.

Methods We compared these two approaches in a prospective, randomized, multi-institutional study. The end points were progression-free survival, overall survival, and life-threatening or fatal toxic effects. Two hundred eligible patients were randomly assigned to receive CHOP plus radiotherapy, and 201 received CHOP alone.

Results Patients treated with three cycles of CHOP plus radiotherapy had significantly better progression-free survival (P=0.03) and overall survival (P=0.02) than patients treated with CHOP alone. The five-year estimates of progression-free survival for patients receiving CHOP plus radiotherapy and for patients receiving CHOP alone were 77 percent and 64 percent, respectively. The five-year estimates of overall survival for patients receiving CHOP plus radiotherapy and for patients receiving CHOP alone were 82 percent and 72 percent, respectively. The adverse effects included one death in each treatment group. Life-threatening toxic effects of any type were seen in 61 of 200 patients treated with CHOP plus radiotherapy and in 80 of 201 patients treated with CHOP alone (P=0.06). The left ventricular function was decreased in seven patients who received CHOP alone, whereas no cardiac events were recorded in the group receiving CHOP plus radiotherapy (P=0.02).

Conclusions Three cycles of CHOP followed by involved-field radiotherapy are superior to eight cycles of CHOP alone for the treatment of localized intermediate- and high-grade non-Hodgkin's lymphoma.

Source Information

From the Arizona Cancer Center, University of Arizona, Tucson (T.P.M., J.R.C., C.M.S., T.M.G., E.C.); the Southwest Oncology Group Statistical Center, Seattle (S.D., M.L., S.C.); the Cleveland Clinic Foundation, Cleveland (D.J.A.); and the Cardinal Bernardin Cancer Center, Loyola University Medical Center, Maywood, Ill. (R.I.F.).

Address reprint requests to Dr. Miller at the Southwest Oncology Group, Operations Office, 14980 Omicron Dr., San Antonio, TX 78245-3217.

Full Text of this Article

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Extract | Full Text  
N Engl J Med 1998; 339:1475-1477, Nov 12, 1998. Correspondence

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