[Initial anthracycline-based chemotherapy without radiotherapy in patients older than 70 years with localized...

Between July 1982 and November 1992 twenty-six patients older than 70 years with localized stage of non-Hodgkin's lymphoma (NHL) arising from Waldeyer's ring were treated with initial chemotherapy consisting of anthracycline-based combination chemotherapies without regional radiotherapy in Saitama Cancer Center and Chiba Cancer Center. Patients with stage I-II were eligible for this study. There were 9 men and 17 women, ranging in age from 70 to 86 years with a median age of 77. Eight patients were aged over 80. The initial chemotherapy consisted of 400 mg/m2 of cyclophosphamide iv on day 1, either 40 mg/m2 of adriamycin or 40 mg/m2 of epirubicin iv on day 1, 2.0 mg/m2 of vindesine iv on day 1 and 40 mg/m2 of prednisolone po for 5 days. This combination chemotherapy was repeated every 4 weeks and given 6-10 cycles. There were 4 cass of stage I disease and 22 cases of stage II disease. Histologic subtypes were follicular large (1 case), diffuse large (16 cases), diffuse mixed (4 cases), and diffuse medium (4 cases). A complete response was obtained in 23 (88%) of the 26 patients. The median courses of chemotherapies in complete responders were 6 (range, 2-10). There were 7 recurrences among the 23 responders. The complete response was well sustained with an actuarial relapse-free survival of 59% at 5 years. To date 9 patients expired, four after a recurrence, four under complete remission and the remaining one without attaining CR. The survival curve of all patients became flat at 56 months and was well sustained with an actuarial survival of 34%.