Hayhoe F G
Clin Radiol. 1981 Sep;32(5):547-52. doi: 10.1016/s0009-9260(81)80185-7.
This report describes two comparisons of combination chemotherapy (COP) with chlorambucil in the management of Stages III, IV Grade 1 non-Hodgkin's lymphoma. The first prospective randomised study was carried out by the BNLI between 1974 and 1976. In 1976, initial analyses of 90 assessable patients indicated that COP was more effective than chlorambucil but it was considered by the BNLI collaborators that chlorambucil should not be discarded because it was not much more acceptable to both patients and doctors. Long-term follow-up of this early trial indicated that the decision not to give up chlorambucil was justified. Examination of the results in 1980, which included 130 assessable cases, showed identical recurrence-free survival rates in the two groups. In the second study starting in 1977, the initial comparison was between chlorambucil and COP, but if progressive improvement was not achieved by three months the patient was regarded as a non-responder and switched to the other arm. Patients were also drawn for maintenance (with chlorambucil) or not at the time for entry into the trial. Analysis of the first 180 patients show similar complete remission rates, actuarial survival rates and recurrence-free survival rates. There seems no advantage in using COP as first-line treatment rather than single agent chlorambucil, provided that non-responders are treated subsequently with combination chemotherapy.
本报告描述了在Ⅲ期、Ⅳ期1级非霍奇金淋巴瘤的治疗中联合化疗（COP）与苯丁酸氮芥的两项比较。第一项前瞻性随机研究由英国国家淋巴瘤研究组（BNLI）于1974年至1976年进行。1976年，对90例可评估患者的初步分析表明，COP比苯丁酸氮芥更有效，但BNLI的合作者认为不应摒弃苯丁酸氮芥，因为它对患者和医生来说接受度并没有低太多。对这项早期试验的长期随访表明，不放弃苯丁酸氮芥的决定是合理的。1980年对结果的检查（包括130例可评估病例）显示，两组的无复发生存率相同。在始于1977年的第二项研究中，最初的比较是在苯丁酸氮芥和COP之间进行，但如果三个月内未取得逐步改善，患者则被视为无反应者并转至另一组。患者在进入试验时也被分为接受维持治疗（使用苯丁酸氮芥）或不接受维持治疗。对前180例患者的分析显示，完全缓解率、精算生存率和无复发生存率相似。如果对无反应者随后采用联合化疗，那么作为一线治疗使用COP而非单一药物苯丁酸氮芥似乎并无优势。
