Japanese multicenter phase II study of CHOP followed by radiotherapy in stage I-II, diffuse large B-cell lymphoma of the stomach.

Abstract

CHOP (cyclophosphamide, doxorubicin, vincristine and prednisone) followed by radiotherapy is regarded as standard care for localized aggressive lymphoma; however, prospective confirmation of its applicability to localized primary gastric lymphoma is inadequate, and most patients in Japan have been initially treated with gastrectomy. We conducted a multicenter phase II study to evaluate the feasibility and efficacy of the non-surgical treatment. Eligibility criteria required primary gastric diffuse large B-cell lymphoma, stage I-II(1), age 20-75, performance status 0-1 and adequate organ function. Treatment consisted of three cycles of CHOP followed by radiotherapy 40.5 Gy. Fifty-five patients were enrolled between December 1999 and February 2003, and 52 eligible patients were analyzed. Patient characteristics were as follows: median age, 61 years; 28 men, 24 women; 36 with stage I, 16 with stage II(1); 47 with a low International Prognostic Index (IPI) and five with a low-intermediate IPI. All but one patient completed planned treatment. No serious complications including massive hemorrhage or perforation were observed. A complete response was achieved in 48 of the 52 patients (92%, 95% confidence interval: 82-98%) and progressive disease in three. Two patients underwent salvage gastrectomy due to disease persistence or recurrence. With a median follow-up period of 28 months, 2-year progression-free and overall survivals were 88 and 94%, respectively. CHOP followed by radiotherapy is safe and highly effective in localized gastric diffuse large B-cell lymphoma. This organ-preserving treatment should be considered as a very reasonable therapeutic option.

• Authors: Satoshi Ishikura, Kensei Tobinai, Atsushi Ohtsu, Shigeo Nakamura, Tadashi Yoshino, Ichiro Oda, Toshiyuki Takagi, Kiyomi Mera, Yoshikazu Kagami, Kuniaki Itoh, Yoshio Tamaki, Junji Suzumiya, Masafumi Taniwaki, Seiichiro Yamamoto
• Journal: Cancer science (Cancer Sci) Vol. 96 Issue 6 Pg. 349-52 (Jun 2005) ISSN: 1347-9032 [Print] England
• PMID: 15958057 (Publication Type: Clinical Trial, Clinical Trial, Phase II, Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)

Chemical References

• Vincristine
• Doxorubicin
• Cyclophosphamide
• Prednisone

Topics

• Administration, Oral
• Adult
• Aged
• Antineoplastic Combined Chemotherapy Protocols (administration & dosage)
• Combined Modality Therapy
• Cyclophosphamide (administration & dosage)
• Disease Progression
• Doxorubicin (administration & dosage)
• Female
• Gastrectomy
• Humans
• Infusions, Intravenous
• Lymphoma, B-Cell (drug therapy, radiotherapy)
• Lymphoma, Large B-Cell, Diffuse (drug therapy, radiotherapy)
• Male
• Middle Aged
• Prednisone (administration & dosage)
• Stomach Neoplasms (drug therapy, radiotherapy)
• Survival Analysis
• Treatment Outcome
• Vincristine (administration & dosage)