ORLANDO, FloridaUpdated data from two separate studies ratify earlier results showing that following CHOP (cyclophosphamide [Cytoxan, Neosar], doxorubicin(Drug information on doxorubicin) HCl, vincristine [Oncovin], prednisone(Drug information on prednisone)) with radiation improves results for patients with early- or limited-stage non-Hodgkin’s lymphoma (NHL).
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Stanford University in California noted that the study had "the advantage of mature follow-up, but the disadvantage of outdated classification," having been done before the International Prognostic Index (IPI) or the WHO and REAL classifications became standard.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.