Non-Hodgkin's lymphoma, poorly differentiated lymphocytic and mixed cell types. Results of sequential staging procedures, response to therapy, and survival of 100 patients
The results of sequential staging procedures including laparotomy, radiotherapy, and combination chemotherapy are reported for 100 patients with poorly differentiated lymphocytic (PDL) and mixed cell (MC) non-Hodgkin's lymphoma (NHL). Twelve patients were found to have localized disease, pathologic stage (PS) I or II; 88 patients had PS III or IV disease. Bone marrow biopsy showed a high incidence of involvement and advanced 34% of the patients from PS I, II, and III to PS IV. Staging laparotomy has a very limited role in the evaluation of these patients. All of 12 patients with PS I and II NHL were treated with radiotherapy; at 5 years, they had 100% survival, 80% being disease-free. Fifteen patients with PS III disease were treated with total nodal radiotherapy (TNRT) alone and had a median disease-free survival of 41 months. The remaining patients with PS III and IV disease were treated with chemotherapy consisting of vincristine and prednisone (V and P); cyclophosphamide, vincristine (Oncovin), procarbazine, and prednisone (COPP); cyclophosphamide, vincristine (Oncovin), adriamycin, and prednisone (COPA); or palliative therapy consisting of chlorambucil and prednisone. Two-year and 4-year survivals for patients with diffuse lymphoma were 93% and 60%, respectively; for patients with +2 nodular lymphoma, 80% and 30%; and for patients with nodular lymphomas, 76 to 93% and 50%, respectively. Treatment with COPP showed no advantage over V and P, palliative therapy, or TNRT for patients with +2 nodular and nodular disease. The likelihood of cure appears most promising for patients in complete remission (CR) with diffuse lymphoma; patients in CR with nodular lymphoma show a high rate of relapse over 5 years of observation. We conclude that staging laparotomy in PDL and MC NHL is of limited value, and that the role of aggressive chemotherapy for patients with +2 nodular and nodular lymphoma needs to be redefined.
- Research Organization:
- Univ. of Chicago
- OSTI ID:
- 6724704
- Journal Information:
- Cancer; (United States), Vol. 42:1
- Country of Publication:
- United States
- Language:
- English
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ANTINEOPLASTIC DRUGS
TOXICITY
CHEMOTHERAPY
EFFICIENCY
GALLIUM 67
SCINTISCANNING
LIVER
LYMPHOMAS
DIAGNOSIS
RADIOTHERAPY
PATIENTS
SURVIVAL TIME
SKELETON
SPLEEN
TECHNETIUM 99
BETA DECAY RADIOISOTOPES
BETA-MINUS DECAY RADIOISOTOPES
BODY
COUNTING TECHNIQUES
DAYS LIVING RADIOISOTOPES
DIAGNOSTIC TECHNIQUES
DIGESTIVE SYSTEM
DISEASES
DRUGS
ELECTRON CAPTURE RADIOISOTOPES
GALLIUM ISOTOPES
GLANDS
HOURS LIVING RADIOISOTOPES
INTERMEDIATE MASS NUCLEI
ISOMERIC TRANSITION ISOTOPES
ISOTOPES
MEDICINE
NEOPLASMS
NUCLEAR MEDICINE
NUCLEI
ODD-EVEN NUCLEI
ORGANS
RADIOISOTOPE SCANNING
RADIOISOTOPES
RADIOLOGY
TECHNETIUM ISOTOPES
THERAPY
YEARS LIVING RADIOISOTOPES
550601* - Medicine- Unsealed Radionuclides in Diagnostics
560151 - Radiation Effects on Animals- Man
550600 - Medicine