title: A randomized British National Lymphoma Investigation trial of CHOP vs. a weekly multi-agent regimen (PACEBOM) in patients with histologically aggressive non-Hodgkin's lymphoma.
abstract: BACKGROUND
  Between 1987 and 1991, the British National Lymphoma Investigation randomized 459 patients with non-Hodgkin's lymphoma with a large-cell component to either CHOP or the PACEBOM regimen.
  
  
  METHODS
  Four hundred fifty-nine eligible patients were included in this trial, four hundred one with diffuse large-cell lymphoma and fifty-eight with diffuse mixed-cell lymphoma according to the Working Formulation. Two hundred twenty-six patients were randomized to receive CHOP and two hundred thirty-three to receive PACEBOM. The two arms of the trial were well balanced for all potential prognostic factors.
  
  
  RESULTS
  The complete remission rate with PACEBOM was 64% and with CHOP 57% (NS). At eight years, the actuarial cause specific survival (CSS) in the PACEBOM arm is 59% compared to 49% in the CHOP arm (P = 0.09). Patients < 50 years of age fared significantly better in the PACEBOM arm both for CSS and overall survival (P = 0.002) and the CSS was also significantly improved in stage IV disease (P = 0.02).
  
  
  CONCLUSIONS
  The mature data from this trial suggest that an etoposide-containing multi-agent weekly regimen can be superior to CHOP.
authors.affiliation: CRC and UCL Cancer Trials Centre, Department of Oncology, Middlesex Hospital, London, UK.
authors.forename: D C
authors.initials: DC
authors.lastname: Linch
authors.forename: P
authors.initials: P
authors.lastname: Smith
authors.forename: B W
authors.initials: BW
authors.lastname: Hancock
authors.forename: P J
authors.initials: PJ
authors.lastname: Hoskin
authors.forename: D C
authors.initials: DC
authors.lastname: Cunningham
authors.forename: A C
authors.initials: AC
authors.lastname: Newland
authors.forename: D
authors.initials: D
authors.lastname: Milligan
authors.forename: P A
authors.initials: PA
authors.lastname: Stevenson
authors.forename: J K
authors.initials: JK
authors.lastname: Wood
authors.forename: K A
authors.initials: KA
authors.lastname: Maclennan
authors.forename: B
authors.initials: B
authors.lastname: Vaughan
authors.forename: G
authors.initials: G
authors.lastname: Vaughan
authors.forename: W M
authors.initials: WM
authors.lastname: Gregory
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001761:Bleomycin / Q000008:administration & dosage; D016009:Chi-Square Distribution; D003520:Cyclophosphamide / Q000008:administration & dosage; D004305:Dose-Response Relationship, Drug; D004317:Doxorubicin / Q000008:administration & dosage; D004334:Drug Administration Schedule; D005047:Etoposide / Q000008:administration & dosage; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016403:Lymphoma, Large B-Cell, Diffuse / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D008228:Lymphoma, Non-Hodgkin / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D011239:Prednisolone / Q000008:administration & dosage; D012720:Severity of Illness Index; D016019:Survival Analysis; D006113:United Kingdom; D014750:Vincristine / Q000008:administration & dosage
chemical_list: D001761:Bleomycin; D014750:Vincristine; D005047:Etoposide; D004317:Doxorubicin; D003520:Cyclophosphamide; D011239:Prednisolone; D008727:Methotrexate