ORLANDO, FloridaUpdated data from two separate studies ratify earlier
results showing that following CHOP (cyclophosphamide [Cytoxan, Neosar],
doxorubicin HCl, vincristine [Oncovin], prednisone) with radiation improves
results for patients with early- or limited-stage non-Hodgkin’s lymphoma
The final results of E1484 showed that radiotherapy was successful in
converting patients with limited-stage diffuse aggressive NHL who had
achieved partial response following treatment with CHOP to complete
response. In a trial conducted by the Southwest Oncology Group (SWOG),
patients with early-stage aggressive NHL receiving CHOP plus radiotherapy
continued to realize survival advantages superior to patients receiving CHOP
alone at greater doses.
New Results, Old System
In reporting the final results of E1484, Sandra J. Horning, MD, of
Stanford University in California noted that the study had "the
advantage of mature follow-up, but the disadvantage of outdated
classification," having been done before the International Prognostic
Index (IPI) or the WHO and REAL classifications became standard.
Patient accrual and randomization ran from October 1984 to September
1992. "The objectives of this study," Dr. Horning explained,
"were to determine the complete response rate and the toxicity of CHOP
for early-stage diffuse aggressive lymphoma, to compare the effect of
involved field radiotherapy after a CHOP-induced remission with end points
of duration of response, survival, sites of relapse, and toxicity, and
lastly to determine the ability of radiotherapy to convert partial
responders to complete responders."
Predominantly Diffuse Large-Cell Lymphomas
Most patients in the study (82%) had diffuse large-cell lymphoma. To be
eligible, patients had to be in stage IE/II/IIE, or to have mediastinal,
retroperitoneal, or bulky disease, defined as 10 cm or larger if stage I.