Cyclophosphamide, doxorubicin, vincristine and prednisone chemotherapy and radiotherapy for stage I intermediate or high grade non-Hodgkin's lymphomas: results of a strategy that adapts radiotherapy dose to the response after chemotherapy
Cyclophosphamide, doxorubicin, vincristine and prednisone chemotherapy and radiotherapy for stage I intermediate or high grade non-Hodgkin's lymphomas: results of a strategy that adapts radiotherapy dose to the response after chemotherapy
复制标题
DOI：
10.1016/s0167-8140(00)00272-3
复制
发表时间：
2001-03-01
影响因子：
5.7
通讯作者：
van 't Veer, MB
中科院分区：
文献类型：
--
作者：
Krol, ADG;Berenschot, HWA;van 't Veer, MB
背景资料：有限周期的环磷酰胺、多柔比星、长春新碱和泼尼松（CHOP）化疗，然后进行累及野放疗是安阿伯I期中或高度非霍奇金淋巴瘤（NHL）的治疗选择。在这种联合治疗模式下，最佳的放射治疗剂量，导致最大的疾病控制和最小的毒性是未知的。在这项回顾性单中心研究中，我们评估了一种综合治疗策略的结果，该策略使放疗剂量适应化疗后的反应，并关注放疗剂量对局部控制和生存的影响。患者和方法：140例NHL安阿伯I期/中、高度恶性IE患者行CHOP方案化疗4个周期后行介入野放疗（IF RT）。CHOP后完全缓解（CR）患者的放疗剂量为26或40戈伊。CHOP后部分缓解（PR）的患者均接受40戈伊。结果：化疗后CR率为67%，放疗后CR率为91%。CHOP后CR者74例接受26戈伊，CHOP后CR者20例接受40戈伊。所有CHOP后PR患者（n = 34）接受40戈伊。接受26或40戈伊的患者复发的位置（在辐射野内或外）没有差异。接受26和40戈伊IF-RT的CHOP后CR患者和CHOP后PR但接受40戈伊IF-RT后CR的患者的5年总生存率（OS）分别为76%、100%和75%，（P = 0.16），5年无病生存率（DFS）分别为69%、90%和75%，结论：接受26或40戈伊IF-RT的患者在复发或生存模式方面无统计学显著差异，但所有亚组中的事件数量均较少。(C)2001爱思唯尔科学爱尔兰有限公司保留所有权利。
Background: A limited number cycles of cyclophosphamide, doxorubicin, vincristine and prednisone (CHOP) chemotherapy followed by involved field radiotherapy is the treatment of choice for Ann Arbor stage I intermediate or high grade non-Hodgkin's lymphomas (NHL). The optimal radiotherapy dose in this combined modality setting, resulting in maximal disease control with minimal toxicity is unknown. In this retrospective single-center study we evaluated the results of a combined modality treatment strategy that adapts the radiotherapy dose to the response after chemotherapy, and focus on the influence of radiotherapy dose on local control and survival.Patients and methods: One hundred and forty patients with NHL Ann Arbor stages I/IE of intermediate or high grade malignancy received four cycles of CHOP chemotherapy followed by involved field radiotherapy (IF-RT). The radiotherapy dose for patients in complete response (CR) after CHOP was either 26 or 40 Gy. Patients in partial response (PR) after CHOP always received 40 Gy. The influence of the radiotherapy dose on treatment outcome was evaluated for patients in CR at the end of treatment (n = 128).Results: CR rates after chemotherapy and after radiotherapy were 67 and 91%, respectively. Seventy-four of the patients in CR after CHOP received 26 Gy, 20 patients in CR after CHOP 40 Gy. All patients in PR after CHOP (n = 34) received 40 Gy. The localization of relapse (within or outside the radiation field) did not differ between patients receiving 26 or 40 Gy. Overall survival (OS) at 5 years for patients in CR after CHOP who received 26 and 40 Gy and for patients in PR after CHOP but CR after 40 Gy IF-RT was 76, 100 and 75%, respectively, (P = 0.16), disease free survival (DFS) at 5 years 69, 90 and 75%, respectively, (P = 0.52).Conclusions: No statistically significant differences in patterns of relapse or survival were found between patients receiving 26 or 40 Gy IF-RT, however the number of events in all subgroups was Small. (C) 2001 Elsevier Science Ireland Ltd. All rights reserved.