Meadows A T, Sposto R, Jenkin R D, Kersey J H, Chilcote R R, Siegel S E, Coccia P F, Rosenstock J, Pringle K C, Stolar C J
Children's Hospital, Philadelphia.
J Clin Oncol. 1989 Jan;7(1):92-9. doi: 10.1200/JCO.1989.7.1.92.
Successful treatment of localized non-Hodgkin's lymphoma (NHL) in childhood with 18 months of cyclophosphamide, vincristine, methotrexate (MTX), and prednisone (COMP) prompted a randomized clinical trial to determine whether a 6-month course of the same therapy was as effective as an 18-month course when combined with local irradiation. Two successive Childrens Cancer Study Group (CCSG) protocols (CCG 551 and CCG 501) entered 232 eligible patients from October 1979 until April 1986. Initially, all children with localized disease were considered eligible, but by a subsequent amendment, those with lymphoblastic (LB) histology were excluded. Hence, the study population consisted of 211 patients with nonlymphoblastic (NLB) and 21 with LB disease. Early relapses (before 6 months) occurred in 13 patients with NLB histology. Late relapses were seen in seven patients, three with LB histology. Among the 104 randomized patients who followed the prescribed therapy, there were four recurrences and no differences between 6-month and 18-month therapy. The overall survival for NLB disease was 91% on CCG 551 and 98% on CCG 501. We conclude that 6 months of COMP is excellent therapy for children with localized NLB NHL.
环磷酰胺、长春新碱、甲氨蝶呤（MTX）和泼尼松（COMP）联合治疗18个月成功治愈儿童局限性非霍奇金淋巴瘤（NHL），这促使开展了一项随机临床试验，以确定当联合局部放疗时，相同疗法的6个月疗程是否与18个月疗程一样有效。儿童癌症研究组（CCSG）的两项连续方案（CCG 551和CCG 501）从1979年10月至1986年4月纳入了232名符合条件的患者。最初，所有局限性疾病患儿均被视为符合条件，但随后的一项修正案将淋巴细胞性（LB）组织学类型的患儿排除在外。因此，研究人群包括211名非淋巴细胞性（NLB）患者和21名LB疾病患者。13例NLB组织学类型的患者出现早期复发（6个月前）。7例患者出现晚期复发，其中3例为LB组织学类型。在104名遵循规定治疗的随机分组患者中，有4例复发，6个月疗程和18个月疗程之间无差异。CCG 551方案中NLB疾病的总生存率为91%，CCG 501方案中为98%。我们得出结论，对于局限性NLB NHL患儿，6个月的COMP方案是极佳的治疗方法。
