title: R-CHOP therapy alone in limited stage diffuse large B-cell lymphoma.
abstract: Long-term observation has identified a pattern of continuing relapse in limited stage diffuse large B-cell lymphoma (DLBCL) treated by three cycles of R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone) plus involved-field irradiation. We retrospectively analysed 190 untreated patients with limited stage DLBCL treated by R-CHOP alone. All the patients were scheduled to undergo primary therapy with six cycles of full-dose R-CHOP. Cases with a dose reduction of more than 20% were excluded from the study. Additional local irradiation was allowed in patients with partial response (PR). Five patients received additional local irradiation after PR at the end of the R-CHOP therapy. The median observation period was 52 months. Median age at diagnosis was 63 years. The responses to therapy were 180 complete responses, eight PR, and two progression of disease (PD). The 5-year progression-free survival and 5-year overall survival rates were 84% and 90%, respectively, both in plateau. During the observation period, 29 patients experienced PD. The progression sites were the primary sites in 15 patients, outside the primary sites in 10, and undetermined in four patients. These results suggest that the 'standard' strategy of three cycles of R-CHOP followed by involved-field radiotherapy for limited stage DLBCL could be effectively replaced by six cycles of R-CHOP alone.
authors: Department of Internal Medicine and Clinical Immunology, Yokohama City University Graduate School of Medicine, Yokohama, Japan. cavalier@ch-yamate.dlenet.com
authors: Naoto
authors: N
authors: Tomita
authors: Hirotaka
authors: H
authors: Takasaki
authors: Kazuho
authors: K
authors: Miyashita
authors: Shin
authors: S
authors: Fujisawa
authors: Eriko
authors: E
authors: Ogusa
authors: Shiro
authors: S
authors: Matsuura
authors: Kumiko
authors: K
authors: Kishimoto
authors: Ayumi
authors: A
authors: Numata
authors: Atsuko
authors: A
authors: Fujita
authors: Rika
authors: R
authors: Ohshima
authors: Hideyuki
authors: H
authors: Kuwabara
authors: Maki
authors: M
authors: Hagihara
authors: Chizuko
authors: C
authors: Hashimoto
authors: Sachiya
authors: S
authors: Takemura
authors: Hideyuki
authors: H
authors: Koharazawa
authors: Etsuko
authors: E
authors: Yamazaki
authors: Katsumichi
authors: K
authors: Fujimaki
authors: Jun
authors: J
authors: Taguchi
authors: Rika
authors: R
authors: Sakai
authors: Yoshiaki
authors: Y
authors: Ishigatsubo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D058846:Antibodies, Monoclonal, Murine-Derived / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use*; D003520:Cyclophosphamide / Q000008:administration & dosage; D018450:Disease Progression; D018572:Disease-Free Survival; D004317:Doxorubicin / Q000008:administration & dosage; D004341:Drug Evaluation; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D016403:Lymphoma, Large B-Cell, Diffuse / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011241:Prednisone / Q000008:administration & dosage; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D012307:Risk Factors; D000069283:Rituximab; D016896:Treatment Outcome; D014750:Vincristine / Q000008:administration & dosage; D055815:Young Adult
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D000069283:Rituximab; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011241:Prednisone