title: A long-term follow-up study of prospective 80%-dose CHOP followed by involved-field radiotherapy in elderly lymphoma patients.
abstract: OBJECTIVE
  The purpose of this study was to clarify the long-term clinical outcome of elderly patients with localized aggressive lymphoma and to explore appropriate treatment strategies for this population.
  
  
  METHODS
  Subjects of this multicenter prospective study were untreated patients aged ≥70 years with aggressive Stage IA-IIA lymphoma. Therapy with 80%-dose CHOP (cyclophosphamide 600 mg/m(2), doxorubicin 40 mg/m(2), vincristine 1.1 mg/m(2) and prednisolone 80 mg/day for 5 days) was repeated every 3 weeks. After three cycles of chemotherapy, involved-field radiotherapy was performed with 30-50 Gy in 15-28 fractions.
  
  
  RESULTS
  A total of 24 patients (median age, 75 years; range, 70-84 years) were enrolled. Nineteen patients (79%) had non-bulky tumors <6 cm. The median follow-up period was 7.3 years. The 7-year overall and progression-free survival rates were 78.9% (95% confidence interval, 62.3-95.5) and 65.3% (95% confidence interval, 45.3-85.3), respectively. Six patients developed systemic relapse, two of them after 6 years. The median survival time after relapse was only 5 months (range, 2 weeks-5.2 years). Five patients developed second malignancies, and three other patients died from other causes without lymphoma progression. None of the patients developed local relapse within the radiation field and/or regional relapse in adjacent lymph node areas.
  
  
  CONCLUSIONS
  Although systemic relapses, short survival time after relapse and death from other causes occurred, no loco-regional relapses were observed. Less intensive radiotherapy such as low-dose and small field might not compromise the treatment outcome for this population.
authors: Department of Radiation Oncology, Saku Central Hospital, 197 Usuda, Saku-City, Nagano 384-0301, Japan. nshikama0525@gmail.com
authors: Naoto
authors: N
authors: Shikama
authors: Masahiko
authors: M
authors: Oguchi
authors: Koichi
authors: K
authors: Isobe
authors: Katsumasa
authors: K
authors: Nakamura
authors: Yoshio
authors: Y
authors: Tamaki
authors: Masatoshi
authors: M
authors: Hasegawa
authors: Takeshi
authors: T
authors: Kodaira
authors: Shigeru
authors: S
authors: Sasaki
authors: Yoshikazu
authors: Y
authors: Kagami
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D003520:Cyclophosphamide / Q000008:administration & dosage / Q000009:adverse effects; D018572:Disease-Free Survival; D004305:Dose-Response Relationship, Drug; D004317:Doxorubicin / Q000008:administration & dosage / Q000009:adverse effects; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D016179:Granulocyte Colony-Stimulating Factor / Q000008:administration & dosage; D006801:Humans; D053208:Kaplan-Meier Estimate; D008207:Lymphatic Metastasis; D008228:Lymphoma, Non-Hodgkin / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis; D009367:Neoplasm Staging; D009503:Neutropenia / Q000139:chemically induced / Q000517:prevention & control; D011241:Prednisone / Q000008:administration & dosage / Q000009:adverse effects; D011379:Prognosis; D011446:Prospective Studies; D011879:Radiotherapy Dosage; D018714:Radiotherapy, Adjuvant; D013997:Time Factors; D016896:Treatment Outcome; D014750:Vincristine / Q000008:administration & dosage / Q000009:adverse effects
chemical_list: D016179:Granulocyte Colony-Stimulating Factor; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011241:Prednisone