Combined modality consisting of chemotherapy and radiotherapy for limited-stage, histologically diffuse type non-Hodgkin's lymphoma of head and neck

During the period of 1975 to 1982, 32 patients with limited stage, histologically diffuse type non-Hodgkin's lymphomas of the head and neck were treated with adjuvant chemotherapy consisting of vincristine (VCR), cyclophosphamide (CPM) and prednisolone (PDN) after radiation therapy (adjuvant chemotherapy group: Group I). In the next series of study, 29 patients were treated initially with combination chemotherapy (first induction chemotherapy was consisted of VCR, CPM and PDN (VCP therapy), and second induction of adriamycin, etoposide and prednisolone (AEP therapy), and patients who attained complete remission (CR) by initial chemotherapy received radiation therapy to the initial sites during 7 years from 1983 to 1989 (initial chemotherapy group: Group II). The following results were obtained. In Group I of 32 patients, 11 patients relapsed and 12 died (including 3 deaths by other diseases), resulted in the relapse free survival curve and survival curve being plateau at 56% and 63%. In Group II, 28 of 29 patients (96.6%) attained CR by VCP or AEP therapy and 27 of 28 CR patients received radiation therapy to the initial sites, and relapse free survival curve became plateau at 67%. Survival rate at 100 months was 62%. The differences in relapse free survival and survival rates between the two groups were not statistically significant. Relapses occurred on other than the primary sites in the most relapsed patients in both groups. These results suggest that more intensive initial chemotherapy is necessary for this disease. (author)