Chemotherapy with or without radiotherapy in limited-stage diffuse aggressive non-Hodgkin's lymphoma: Eastern Cooperative Oncology Group Study 1484

Sandra J. Horning, Edie Weller, KyungMann Kim, John D. Earle, Michael J. O'Connell, Thomas Matthew Habermann, John H. Glick

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Abstract

Purpose: To compare low-dose (30 Gy) radiotherapy (RT) with observation (OBS) in limited-stage aggressive lymphoma patients achieving complete remission (CR) after chemotherapy, and to measure conversion from partial response (PR) to CR with high-dose (40 Gy) RT. Patients and Methods: From 1984 to 1992, stage I (with risk factors) and II adults with diffuse aggressive lymphoma in CR after eight cycles of cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) were randomly assigned to 30 Gy involved-field RT or OBS. PR patients received 40 Gy RT. Results: Among 172 CR patients, the 6-year disease-free survival (DFS) was 73% for low-dose RT versus 56% for OBS (two-sided P = .05). Failure-free survival (two-sided P = .06), and time to progression (two-sided P = .06) also favored RT. Intent-to-treat analyses yielded similar results. No survival differences were observed. Three RT versus 15 OBS patients relapsed in initial disease sites. At 6 years, failure-free survival was 63% in PR patients; conversion to CR did not significantly influence clinical outcome. Conclusion: For patients in CR after CHOP, low-dose RT prolonged DFS and provided local control, but no survival benefit was observed. The majority of PR patients were event-free at 6 years despite residual radiographic abnormalities. Future efforts should be directed toward improved imaging and more effective systemic therapies.

Original languageEnglish (US)
Pages (from-to)3032-3038
Number of pages7
JournalJournal of Clinical Oncology
Volume22
Issue number15
DOIs
StatePublished - 2004

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Non-Hodgkin's Lymphoma
Radiotherapy
Drug Therapy
Observation
Survival
Disease-Free Survival
Vincristine
Prednisone
Doxorubicin
Cyclophosphamide
Lymphoma

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

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Chemotherapy with or without radiotherapy in limited-stage diffuse aggressive non-Hodgkin's lymphoma : Eastern Cooperative Oncology Group Study 1484. / Horning, Sandra J.; Weller, Edie; Kim, KyungMann; Earle, John D.; O'Connell, Michael J.; Habermann, Thomas Matthew; Glick, John H.

In: Journal of Clinical Oncology, Vol. 22, No. 15, 2004, p. 3032-3038.

Research output: Contribution to journalArticle

Horning, Sandra J. ; Weller, Edie ; Kim, KyungMann ; Earle, John D. ; O'Connell, Michael J. ; Habermann, Thomas Matthew ; Glick, John H. / Chemotherapy with or without radiotherapy in limited-stage diffuse aggressive non-Hodgkin's lymphoma : Eastern Cooperative Oncology Group Study 1484. In: Journal of Clinical Oncology. 2004 ; Vol. 22, No. 15. pp. 3032-3038.
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abstract = "Purpose: To compare low-dose (30 Gy) radiotherapy (RT) with observation (OBS) in limited-stage aggressive lymphoma patients achieving complete remission (CR) after chemotherapy, and to measure conversion from partial response (PR) to CR with high-dose (40 Gy) RT. Patients and Methods: From 1984 to 1992, stage I (with risk factors) and II adults with diffuse aggressive lymphoma in CR after eight cycles of cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) were randomly assigned to 30 Gy involved-field RT or OBS. PR patients received 40 Gy RT. Results: Among 172 CR patients, the 6-year disease-free survival (DFS) was 73{\%} for low-dose RT versus 56{\%} for OBS (two-sided P = .05). Failure-free survival (two-sided P = .06), and time to progression (two-sided P = .06) also favored RT. Intent-to-treat analyses yielded similar results. No survival differences were observed. Three RT versus 15 OBS patients relapsed in initial disease sites. At 6 years, failure-free survival was 63{\%} in PR patients; conversion to CR did not significantly influence clinical outcome. Conclusion: For patients in CR after CHOP, low-dose RT prolonged DFS and provided local control, but no survival benefit was observed. The majority of PR patients were event-free at 6 years despite residual radiographic abnormalities. Future efforts should be directed toward improved imaging and more effective systemic therapies.",
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T1 - Chemotherapy with or without radiotherapy in limited-stage diffuse aggressive non-Hodgkin's lymphoma

T2 - Eastern Cooperative Oncology Group Study 1484

AU - Horning, Sandra J.

AU - Weller, Edie

AU - Kim, KyungMann

AU - Earle, John D.

AU - O'Connell, Michael J.

AU - Habermann, Thomas Matthew

AU - Glick, John H.

PY - 2004

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N2 - Purpose: To compare low-dose (30 Gy) radiotherapy (RT) with observation (OBS) in limited-stage aggressive lymphoma patients achieving complete remission (CR) after chemotherapy, and to measure conversion from partial response (PR) to CR with high-dose (40 Gy) RT. Patients and Methods: From 1984 to 1992, stage I (with risk factors) and II adults with diffuse aggressive lymphoma in CR after eight cycles of cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) were randomly assigned to 30 Gy involved-field RT or OBS. PR patients received 40 Gy RT. Results: Among 172 CR patients, the 6-year disease-free survival (DFS) was 73% for low-dose RT versus 56% for OBS (two-sided P = .05). Failure-free survival (two-sided P = .06), and time to progression (two-sided P = .06) also favored RT. Intent-to-treat analyses yielded similar results. No survival differences were observed. Three RT versus 15 OBS patients relapsed in initial disease sites. At 6 years, failure-free survival was 63% in PR patients; conversion to CR did not significantly influence clinical outcome. Conclusion: For patients in CR after CHOP, low-dose RT prolonged DFS and provided local control, but no survival benefit was observed. The majority of PR patients were event-free at 6 years despite residual radiographic abnormalities. Future efforts should be directed toward improved imaging and more effective systemic therapies.

AB - Purpose: To compare low-dose (30 Gy) radiotherapy (RT) with observation (OBS) in limited-stage aggressive lymphoma patients achieving complete remission (CR) after chemotherapy, and to measure conversion from partial response (PR) to CR with high-dose (40 Gy) RT. Patients and Methods: From 1984 to 1992, stage I (with risk factors) and II adults with diffuse aggressive lymphoma in CR after eight cycles of cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) were randomly assigned to 30 Gy involved-field RT or OBS. PR patients received 40 Gy RT. Results: Among 172 CR patients, the 6-year disease-free survival (DFS) was 73% for low-dose RT versus 56% for OBS (two-sided P = .05). Failure-free survival (two-sided P = .06), and time to progression (two-sided P = .06) also favored RT. Intent-to-treat analyses yielded similar results. No survival differences were observed. Three RT versus 15 OBS patients relapsed in initial disease sites. At 6 years, failure-free survival was 63% in PR patients; conversion to CR did not significantly influence clinical outcome. Conclusion: For patients in CR after CHOP, low-dose RT prolonged DFS and provided local control, but no survival benefit was observed. The majority of PR patients were event-free at 6 years despite residual radiographic abnormalities. Future efforts should be directed toward improved imaging and more effective systemic therapies.

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