Japanese multicenter phase II study of CHOP followed by radiotherapy in stage I-II1, diffuse large B-cell lymphoma of the stomach

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

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42 Citations (Scopus)


CHOP (clophosphamide, 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-II1, 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 II1; 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.

Original languageEnglish
Pages (from-to)349-352
Number of pages4
JournalCancer Science
Issue number6
Publication statusPublished - Jun 2005

ASJC Scopus subject areas

  • Oncology
  • Cancer Research


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