Adjuvant cyclophosphamide, doxorubicin, vincristine, and prednisone chemotherapy after radiation therapy in stage I low‐grade and intermediate‐grade non‐Hodgkin lymphoma: Results of a prospective randomized study Journal Article


Authors: Yahalom, J.; Varsos, G.; Fuks, Z.; Myers, J.; Clarkson, B. D.; Straus, D. J.
Article Title: Adjuvant cyclophosphamide, doxorubicin, vincristine, and prednisone chemotherapy after radiation therapy in stage I low‐grade and intermediate‐grade non‐Hodgkin lymphoma: Results of a prospective randomized study
Abstract: Background. In a prospective randomized manner, this study evaluated the effect of adjuvant chemotherapy (cyclophosphamide, doxorubicin, vincristine, and prednisone; CHOP) in patients with Stage I non‐Hodgkin lymphoma (NHL) who have achieved a complete response (CR) after radiation therapy (RT). Methods. Forty‐four patients with clinical or pathologic Stage I intermediate‐grade or low‐grade NHL were randomized to receive regional RT alone (median dose, 40 Gy) or regional RT followed by six cycles of CHOP chemotherapy. There were no differences in clinical and pathologic characteristics between the two treatment groups. Results. The median follow‐up was 7 years (range, 2–10 years). The actuarial relapse‐free survival (RFS) rate for the RT plus CHOP group at 7 years was 83% compared with 47% (P < 0.03) for the RT‐alone group. The overall survival (OS) for the two groups was 88% and 66%, respectively (P = 0.2). In patients with intermediate‐grade NHL, the 7‐year actuarial RFS for RT and CHOP was 86% compared with 20% for RT alone (P = 0.004). The corresponding actuarial survival rates were 92% and 47%, respectively (P ‐ 0.08). In patients with low‐grade histologic findings, the addition of adjuvant CHOP did not improve RFS (P = 0.6) or OS. All relapses in this study were at sites remote from the initially involved areas, and in 5 of 11 patients (45%), there were recurrences 5 years or longer after initial treatment. Conclusions. This study showed that adjuvant CHOP chemotherapy significantly improves RFS in patients with Stage I intermediate‐grade NHL who achieve a CR after regional‐field RT. The chemotherapeutic regimen favorably affected their probability of survival. Copyright © 1993 American Cancer Society
Keywords: adult; cancer chemotherapy; cancer survival; clinical article; aged; survival analysis; survival rate; prednisone; cancer recurrence; doxorubicin; dose response; cancer adjuvant therapy; cancer radiotherapy; chemotherapy, adjuvant; combined modality therapy; chemotherapy; neoplasm staging; cancer grading; prospective studies; antineoplastic combined chemotherapy protocols; combination chemotherapy; cyclophosphamide; vincristine; nonhodgkin lymphoma; adjuvant chemotherapy; radiation therapy; steroid therapy; middle age; human; male; female; priority journal; article; lymphoma, low-grade; support, non-u.s. gov't; lymphoma, intermediate-grade; non‐hodgkin lymphoma
Journal Title: Cancer
Volume: 71
Issue: 7
ISSN: 0008-543X
Publisher: Wiley Blackwell  
Date Published: 1993-04-01
Start Page: 2342
End Page: 2350
Language: English
DOI: 10.1002/1097-0142(19930401)71:7<2342::Aid-cncr2820710728>3.0.Co;2-i
PUBMED: 8453557
PROVIDER: scopus
DOI/URL:
Notes: Source: Scopus
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MSK Authors
  1. Joachim Yahalom
    417 Yahalom
  2. Zvi Fuks
    320 Fuks
  3. David J Straus
    222 Straus
  4. Jane E Myers
    10 Myers