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A third generation regimen VACOP-B with or without adjuvant radiotherapy for aggressive localized non-Hodgkin's lymphoma: report from the Italian Non-Hodgkin's Lymphoma Co-operative Study Group.

Abstract
The objective of this multicenter prospective study was to determine the clinical efficacy and toxicity of a polychemotherapeutic third generation regimen, VACOP-B, with or without radiotherapy as front-line therapy in aggressive localized non-Hodgkin's lymphoma. Ninety-three adult patients (47 males and 46 females, median age 45 years) with aggressive localized non-Hodgkin's lymphoma, 43 in stage I and 50 in stage II (non-bulky), were included in the study. Stage I patients received VACOP-B for 6 weeks plus involved field radiotherapy and stage II patients received 12 weeks VACOP-B plus involved field radiotherapy on residual masses. Eighty-six (92.5%) achieved complete remission and 4 (4.3%) partial remission. Three patients (3.2%) were primarily resistant. Ten-year probability of survival, progression-free survival and disease-free survival were 87.3, 79.9 and 83.9%, respectively. Eighty-four patients are surviving at a median observation time of 57 months (range: 6-126). Statistical analysis showed no difference between stages I and II in terms of response, ten-year probability of survival, progression-free survival or disease-free survival. Side effects and toxicity were negligible and were similar in the two patient groups. The results of this prospective study suggest that 6 weeks of VACOP-B treatment plus radiotherapy may be the therapy of choice in stage I aggressive non-Hodgkin's lymphoma. Twelve weeks of VACOP-B treatment with or without radiotherapy was shown to be effective and feasible for stage II. These observations need to be confirmed by a phase III study comparing first and third generation protocols in stage I-II aggressive non-Hodgkin's lymphoma.
AuthorsG Santini, C De Souza, S Aversa, C Patti, L Tedeschi, M Candela, A Olivieri, T Chisesi, A Rubagotti, R Centurioni, V Nardi, M Congiu, M Gennaro, M Truini, Italian Non-Hodgkin's Lymphoma Co-operative Study Group
JournalBrazilian journal of medical and biological research = Revista brasileira de pesquisas medicas e biologicas (Braz J Med Biol Res) Vol. 37 Issue 5 Pg. 719-28 (May 2004) ISSN: 0100-879X [Print] Brazil
PMID15107935 (Publication Type: Clinical Trial, Controlled Clinical Trial, Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)
Chemical References
  • Bleomycin
  • Vincristine
  • Etoposide
  • Doxorubicin
  • Cyclophosphamide
  • Prednisone
Topics
  • Adolescent
  • Adult
  • Antineoplastic Combined Chemotherapy Protocols (administration & dosage, adverse effects, therapeutic use)
  • Bleomycin (administration & dosage, adverse effects)
  • Cyclophosphamide (administration & dosage, adverse effects)
  • Doxorubicin (administration & dosage, adverse effects)
  • Etoposide (administration & dosage, adverse effects)
  • Female
  • Humans
  • Italy
  • Lymphoma, Non-Hodgkin (drug therapy)
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Prednisone (administration & dosage, adverse effects)
  • Prospective Studies
  • Radiotherapy, Adjuvant
  • Survival Analysis
  • Treatment Outcome
  • Vincristine (administration & dosage, adverse effects)

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