title: Phase II study of concomitant chemoradiotherapy in bulky refractory or chemoresistant relapsed lymphomas.
abstract: OBJECTIVE
  To evaluate the local efficacy of concomitant chemoradiotherapy in patients with mostly refractory lymphoma.
  
  
  METHODS
  Patients with refractory or chemoresistant-relapsed lymphoma and bulky life-threatening masses were included in this study. A split course of concomitant radiotherapy and chemotherapy (mostly cisplatin and etoposide) was delivered during a 6-week period. Weekly blood tests and a clinical examination using the Radiation Therapy Oncology Group guidelines were performed to assess acute toxicity. The tumor response was evaluated 1-3 months after treatment and at regular follow-up visits.
  
  
  RESULTS
  We enrolled 21 patients in the study between January 1998 and April 2003. Of the 21 patients, 60% had disseminated disease with bulky tumor masses and 85% had refractory lymphoma, of which most had been treated with at least two different chemotherapy regimens before concomitant chemoradiotherapy. Seventy-five percent received regimens containing cisplatinum and etoposide. The median radiation dose was 40 Gy (range, 12-62.5 Gy). Grade 3-4 hematologic toxicity and mucositis was observed in 70% and 30% of cases respectively, without any deaths. The overall response and complete remission rate was 70% and 20%, respectively. The 1-year overall survival and local progression-free survival rate was 20.4% and 54%, respectively. Three patients with localized disease were still alive 16, 33, and 48 months after treatment.
  
  
  CONCLUSIONS
  Concomitant chemoradiotherapy for refractory or chemoresistant-relapsed lymphoma induced high hematologic toxicity, but seemed adequate for controlling local bulky tumor masses. No toxicity-related death was observed.
authors.affiliation: Department of Radiation Oncology, Institut Gustave Roussy, Villejuif 94805, France. girinsky@igr.fr
authors.forename: Theodore
authors.initials: T
authors.lastname: Girinsky
authors.forename: Simona
authors.initials: S
authors.lastname: Lapusan
authors.forename: Vincent
authors.initials: V
authors.lastname: Ribrag
authors.forename: Serge
authors.initials: S
authors.lastname: Koscielny
authors.forename: Christophe
authors.initials: C
authors.lastname: Ferme
authors.forename: Patrice
authors.initials: P
authors.lastname: Carde
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002945:Cisplatin / Q000008:administration & dosage; D019008:Drug Resistance, Neoplasm; D005047:Etoposide / Q000008:administration & dosage; D005260:Female; D006801:Humans; D016393:Lymphoma, B-Cell / Q000188:drug therapy / Q000532:radiotherapy; D008224:Lymphoma, Follicular / Q000188:drug therapy / Q000532:radiotherapy; D016403:Lymphoma, Large B-Cell, Diffuse / Q000188:drug therapy / Q000532:radiotherapy; D020522:Lymphoma, Mantle-Cell / Q000188:drug therapy / Q000532:radiotherapy; D008228:Lymphoma, Non-Hodgkin / Q000188:drug therapy* / Q000401:mortality / Q000532:radiotherapy*; D016399:Lymphoma, T-Cell / Q000188:drug therapy / Q000532:radiotherapy; D008297:Male; D008875:Middle Aged; D011879:Radiotherapy Dosage; D012008:Recurrence; D015996:Survival Rate
chemical_list: D005047:Etoposide; D002945:Cisplatin