185 patients with high grade non-Hodgkin’s lymphoma stages II-IV entered this multicentre trial and were randomized to receive either four cycles of CHOEP (cyclophosphamide 750mg/m2 i.v. d 1, dox-orubicin 50 mg/m2 i.v. d 1, vincristine 2 mg i.v. d 1, etoposide 100 mg/ m2 i.v. d 3–5, prednisolone 100 mg p.o. d 1–5) (treatment arm A), or four cycles of chemotherapy with hCHOP (cyclophosphamide 1,200 mg/m2 i.v. d 1, doxorubicin 40 mg/m2 i.v. d 1 + 2, vincristine 2mg i.v. d 1, prednisolone 100 mg p.o. d 1–5) alternating with IVEP (ifosfamide 1,500 mg/m2 i.v. d 1–5, vindesine 3 mg/m2 i.v. d 1, etoposide 120mg/m2 i.v. d 3–5, prednisolone 100mg p.o. d 1–5) in treatment arm B. After four cycles of chemotherapy an involved field irradiation with a total dose of 35 Gy was given to all patients demonstrated to be in complete or partial remission without persisting extranodal disease. So far, 146 patients have completed treatment and are evaluable for response and survival. A complete response (CR) was seen in 124/146 patients (86%) with 89% CR in arm A vs. 83% CR in arm B. During a median follow-up of 17 months (range 2–40) 30 patients relapsed (16 pts. arm A, 14 pts. arm B). The overall survival at 40 months is projected to be 70% vs. 71 % for arm A and B, respectively. Disease-free survival is projected to be 68% in arm A and 59% in arm B at 40 months. So far, the differences in CR, survival and disease-free survival are not statistically significant. Toxicity of all regimens was acceptable, however, with a significant morbidity and one treatment-related death in patients > 70 years after hCHOP. Main side effects were mild nausea/vomiting, leukopenia and fever/infection associated with leukopenia. In conclusion, both treatment modalities produced high complete remission rates. A longer follow-up will be needed to exclude differences in overall and disease-free survival.

Keywords:
High grade non-Hodgkin’s lymphoma, Combination drug therapy, Radiotherapy, Multicentre randomized trial
This content is only available via PDF.
© 1991 S. Karger AG, Basel
1991
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.