There is little information in the literature on outcomes using
doxorubicin-based
chemotherapy with or without
radiotherapy for early-stage
peripheral T-cell lymphomas. The purpose of this study was to analyze The University of Texas M.D. Anderson
Cancer Center results in such patients. From 1985 to 1998, 39 patients with Stage I or II World Health Organization classification
anaplastic large cell lymphoma (ALCL; n = 20),
peripheral T-cell lymphoma, unspecified (PTCLu; n = 11), or nasal-type NK/
T-cell lymphoma (NKTCL; n = 8) were treated using
doxorubicin-based
chemotherapy (median, 6 cycles) with (n = 24) or without (n = 15)
radiotherapy (median dose, 40 Gy). Median age was 41 years. Median follow-up of surviving patients was 85 months. Even though patients who presented with bulky disease or who achieved less than a complete response to
chemotherapy were the ones typically treated with
combined modality therapy rather than
chemotherapy alone, there was no significant difference in local control (5-year rates: 60 vs. 70%, p = 0.49), progression-free survival (5-year rates: 65 vs. 60%, p = 0.62), or overall survival (5-year rates: 74 vs. 67%, p = 0.47) between the groups treated with
combined modality therapy and
chemotherapy alone. Fifteen (38%) patients relapsed. Twelve relapses were limited to the initial site of disease; two involved the initial site and new sites, and one involved only new sites. Based on the significant risk of relapse at the initial site of disease, different approaches, including
chemotherapy with concomitant
radiotherapy to doses > or = 45 Gy, warrant investigation.