Chemotherapy versus radiotherapy for stage I-II intermediate grade non-Hodgkin's lymphomas

The clinical outcome of 149 patients with Stage I-II intermediate grade non-Hodgkin's lymphomas was analysed. There were 77 (52%) males and 72 (48%) females. Their median age was 58 years. Eighty patients (54%) had Stage I disease and 69 (46%) Stage II. Twenty-nine (20%) of them received radiotherapy only, 75 (50%) doxorubicin-containing chemotherapeutic regimens and 45 (30%) other less intensive chemotherapy. Sixty-two patients had additional radiotherapy following chemotherapy. Patients receiving other less intensive chemotherapy were significantly older (P = 0.0001) and those receiving radiotherapy alone had a significantly higher proportion of Stage I disease (P = 0.007). Patients receiving less intensive chemotherapy had a significantly low complete response (CR) rate. Patients receiving radiotherapy alone had a significantly high relapse rate and low disease-free survival following CR. However, there was no significant difference in overall survival regardless of the mode of therapy. This lack of survival advantage might be related to the effective salvage chemotherapy in some of the radiotherapy failures and the occasional chemotherapy-related mortality. Additional radiotherapy following chemotherapy did not appear to give further benefit.