Haematologica
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Haematologica, Vol 90, Issue 6, 802-809
Copyright © 2005 by Ferrata Storti Foundation

Clinical Trial

Long-term outcome of localized high-grade non-Hodgkin's lymphoma treated with high dose CHOP regimen and involved field radiotherapy: results of a GOELAMS study

M Bernard, G Cartron, P Rachieru, A LeMevel, B Branger, C Le Maignan, C Berthou, C Ghandour, V Delwail, N Milpied, P Cassasus, PS Celigny, D Guyotat, T Lamy, B Desablens, and

BACKGROUND AND OBJECTIVES: Most patients with localized high-grade non-Hodgkin's lymphoma (NHL) can be cured with or without adjuvant radiotherapy. However few data are available on the long-term outcome of these patients. Here we report the results of a prospective study, started in 1984, which was conducted to evaluate the long-term outcome of patients with localized high-grade NHL. DESIGN AND METHODS: In this multicenter, prospective study by the GOELAMS group, 253 patients with localized high-grade NHL were treated with 3 cycles of vindesine, cyclophosphamide, adriamycin and prednisone (VCAP, a high-dose CHOP regimen) followed by involved field radiotherapy (40 Gy). RESULTS: After completion of chemotherapy, 213 patients (84%) entered complete remission (CR) and 30 (12%) obtained a partial remission. Treatment failed in 6 patients (2.5%) and there were 4 toxic deaths (1.5%). Following radiotherapy, 239 (94%) of all patients were in CR. With a median follow-up of 88 months, overall survival and disease-free survival rates were 84% and 85% respectively at five years, and 78% and 82% respectively at ten years. The response to chemotherapy was decisive to survival. We observed 43 relapses (17%) at a median time of 20 months after CR, and 9 patients relapsed after five years. Eleven patients (3%) developed another malignancy in the follow-up period. INTERPRETATION AND CONCLUSIONS: High-dose CHOP followed by locoregional radiotherapy is a feasible treatment for localized high-grade NHL. It has very few complications, a good CR rate and the OS is 78% at 10 years.


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Copyright © 2005 by the Ferrata Storti Foundation.