Brief induction chemotherapy followed by involved-field irradiation for the treatment of localized intermediate- and high-grade non-Hodgkin's lymphoma

In an attempt to assess the effects and toxicity of brief induction chemotherapy plus involved-field irradiation for localized intermediate- and high-grade non-Hodgkin's lymphoma, we conducted a single arm prospective trial between May 1987 and July 1991. Patients received four cycles of a five-drug chemotherapy regimen consisting of cyclophosphamide, doxorubicin, vincristine, prednisolone, and bleomycin (CHOP-Bleo) followed by involved-field irradiation of 30 Gy. Of 32 patients consecutively enrolled, 30 patients had measurable and/or evaluable disease, while two had no evaluable disease, as their major tumors had been surgically removed. All the patients were in complete remission at the conclusion of all treatment. Four patients have relapsed so far and one died of the disease at 17 months. With a median follow-up time of 33 months (range, 8 to 58), the actuarial disease-free survival rate was 82% and the overall survival rate was 96%. The toxicity was generally mild and all the patients received the planned treatment course. This treatment modality appeared to be safe and effective for localized intermediate- and high-grade non-Hodgkin's lymphoma.