title: Significance of tumor size and radiation dose to local control in stage I-III diffuse large cell lymphoma treated with CHOP-Bleo and radiation.
abstract: OBJECTIVE
  The purpose of this study was to evaluate the possible effect of adjunctive involved field (IF) radiotherapy on long-term local control for patients with Ann Arbor Stage I-III diffuse large cell lymphoma (DLCL) who achieved a complete remission on a combined modality program which included cyclophosphamide, doxorubicin, vincristine, prednisone, and Bleomycin (CHOP-Bleo).
  
  
  METHODS
  One hundred and ninety patients with Ann Arbor Stage I-III DLCL were treated with CHOP-Bleo and radiotherapy. Analyses were undertaken to determine (a) response to treatment according to stage, extent of maximum local disease, and irradiation dose either < 40 Gy or > or = 40 Gy and (b) relapse patterns.
  
  
  RESULTS
  A complete remission (CR) was achieved in 162 patients. Among patients who achieved a CR, local control was better for those who received tumor doses of > or = 40 Gy (97%) than for those who received < 40 Gy (83%) (p = 0.002.) Among those with extensive local disease, the corresponding control rates were 88% and 71%, respectively. A study of distant relapse patterns following a CR showed that the first relapse usually involved an extranodal site.
  
  
  CONCLUSIONS
  Radiotherapy was an effective adjunctive treatment to CHOP-Bleo for patients with stage I-III DLCL who achieved a CR. Patterns of relapse suggested that total nodal irradiation (TNI) possibly could have benefited a small subset of patients.
authors.affiliation: Department of Radiotherapy, University of Texas M. D. Anderson Cancer Center, Houston 77030.
authors.forename: L M
authors.initials: LM
authors.lastname: Fuller
authors.forename: M J
authors.initials: MJ
authors.lastname: Krasin
authors.forename: W S
authors.initials: WS
authors.lastname: Velasquez
authors.forename: P K
authors.initials: PK
authors.lastname: Allen
authors.forename: P
authors.initials: P
authors.lastname: McLaughlin
authors.forename: M A
authors.initials: MA
authors.lastname: Rodriguez
authors.forename: F B
authors.initials: FB
authors.lastname: Hagemeister
authors.forename: F
authors.initials: F
authors.lastname: Swan
authors.forename: F
authors.initials: F
authors.lastname: Cabanillas
authors.forename: J L
authors.initials: JL
authors.lastname: Palmer
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols; D001761:Bleomycin / Q000627:therapeutic use; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000627:therapeutic use; D004317:Doxorubicin / Q000627:therapeutic use; D006801:Humans; D016403:Lymphoma, Large B-Cell, Diffuse / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy / Q000628:therapy*; D009367:Neoplasm Staging; D011241:Prednisone / Q000627:therapeutic use; D011446:Prospective Studies; D012008:Recurrence; D016019:Survival Analysis; D014750:Vincristine / Q000627:therapeutic use
chemical_list: D001761:Bleomycin; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011241:Prednisone