Young R C, Johnson R E, Canellos G P, Chabner B A, Brereton H D, Berard C W, DeVita V T
Cancer Treat Rep. 1977 Sep;61(6):1153-9.
Ninety-nine previously untreated patients with stage III and IV malignant lymphoma were randomized to receive either cyclic combination chemotherapy (50 patients) or extensive "systemic" radiotherapy (49 patients). Histologic classification included nodular poorly differentiated lymphoma (54 patients), nodular mixed lymphoma (21 patients), and diffuse poorly differentiated lymphoma (24 patients). High overall response rates were seen with either approach (90% for radiotherpy; 86% for chemotherapy) and complete remission were relatively common (60%--80%). Overall median survival of all patients in this trial will exceed 5 years regardless of the induction therapy used; however, disease-free survival is not commonly achieved with either regimen. Relapse-free survival rates at 4-year followup, regardless of induction regimen, are 13% for diffuse lymphomas and 24% for nodular lymphomas. The second prospective trial attempts to use a combined approach and compares cyclic combination chemotherapy with total-body irradiation and combination chemotherapy. Initial results on 34 patients indicate high overall response rates (100%) and similar complete remission rates (64%--67%). With 14 months' median followup no patients in either arm of the trial have died but relatively equal numbers have relapsed.
99例先前未经治疗的Ⅲ期和Ⅳ期恶性淋巴瘤患者被随机分为两组，分别接受周期性联合化疗（50例患者）或广泛的“全身”放疗（49例患者）。组织学分类包括结节性低分化淋巴瘤（54例患者）、结节性混合淋巴瘤（21例患者）和弥漫性低分化淋巴瘤（24例患者）。两种治疗方法均显示出较高的总体缓解率（放疗为90%；化疗为86%），完全缓解相对常见（60% - 80%）。无论采用何种诱导治疗，该试验中所有患者的总体中位生存期都将超过5年；然而，两种治疗方案通常都无法实现无病生存。无论诱导方案如何，在4年随访时，弥漫性淋巴瘤的无复发生存率为13%，结节性淋巴瘤为24%。第二项前瞻性试验尝试采用联合治疗方法，并比较周期性联合化疗与全身照射及联合化疗。对34例患者的初步结果显示总体缓解率较高（100%），完全缓解率相似（64% - 67%）。中位随访14个月时，试验的任何一组均无患者死亡，但复发的患者数量相对相等。
