Primary chemotherapy followed by radiotherapy for localized non-Hodgkin's lymphomas: a preliminary report

Twenty-eight evaluable patients with clinical stage I-II of non-Hodgkin's lymphoma were treated with primary chemotherapy followed by involved field radiotherapy. The frequency of the follicular versus diffuse histological pattern was 14.3 versus 85.7%, and 24/28 (86%) of patients were in stage II. No lymphoma examined was identified as T-cell in origin. A complete response was obtained in 21 (78%) of 27 patients with measurable disorder. [Gastrectomy rendered one patient disease-free survival, and one partially responded showing a complete response after radiotherapy.] Sixteen (76%) of the 21 employed for complete response. After 36 months, elapsed disease-free survival was rated at 100% together with actuarial survival of all patients at 81%. Chemotherapy contributed to reduce the radiation dosage to 3000 rads and to control the areas infiltrated with preexisting tumors. These findings, although the median follow-up time in our study remains short (28 months), provide a strong rationale for further clinical trials of primary chemotherapy, followed by regional radiotherapy for localized stages of non-Hodgkin's lymphomas.