Restaging laparotomy in the management of the non-Hodgkin lymphomas
The intensity of treatment and the extent of restaging necessary to document the level of response to therapy in patients with non-Hodgkin lymphoma (NHL) remains controversial. One hundred patients with advanced non-Hodgkin lymphoma were randomized to treatment with cyclophosphamide, vincristine, plus prednisone or cyclophosphamide, doxorubicin, vincristine, plus prednisone combination chemotherapy. After induction therapy sequential noninvasive restaging including lymphagiogram and /sup 67/Ga scan yielded 33 patients in clinical complete remission and 38 patients in partial remission. Twenty of these 38 patients in partial remission had complete normalization of all clinical and chemical tests (apparent clinical partial remission); however, lymphangiogram, gallium scan, abdominal sonogram, or abdominal CAT scan remained abnormal. In these 20 patients in apparent clinical partial remission, exploratory laparotomy was performed to further assess disease status. Laparotomy revealed evidence of residual disease in only four patients (20%). When correlated with the laparotomies the accuracy of repeat lymphangiograms and gallium scans was 17% and 50% respectively. Thus, restaging lymphangiogram and gallium scan in NHL patients in apparent clinical partial remission are inaccurate, and second look operations are recommended for accurate appraisal of response to therapy. The assessment of true complete remission should help define the role of aggressive treatment.
- Research Organization:
- University of Maryland Cancer Center, University of Maryland Hospital, Baltimore
- OSTI ID:
- 6421743
- Journal Information:
- Med. Pediatr. Oncol.; (United States), Journal Name: Med. Pediatr. Oncol.; (United States) Vol. 10:5; ISSN MPOND
- Country of Publication:
- United States
- Language:
- English
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550901 -- Pathology-- Tracer Techniques
59 BASIC BIOLOGICAL SCIENCES
62 RADIOLOGY AND NUCLEAR MEDICINE
BETA DECAY RADIOISOTOPES
CHEMOTHERAPY
DAYS LIVING RADIOISOTOPES
DIAGNOSTIC USES
DISEASES
DOCUMENT TYPES
ELECTRON CAPTURE RADIOISOTOPES
EVALUATION
GALLIUM 67
GALLIUM ISOTOPES
INTERMEDIATE MASS NUCLEI
ISOTOPES
LYMPHOMAS
NEOPLASMS
NUCLEI
ODD-EVEN NUCLEI
PATENTS
PATHOLOGY
RADIOISOTOPES
THERAPY
USES