Parlier Y, Gorin N C, Najman A, Stachowiak J, Duhamel G
Cancer. 1982 Aug 1;50(3):401-9. doi: 10.1002/1097-0142(19820801)50:3<401::aid-cncr2820500304>3.0.co;2-4.
Between January 1973 and January 1979, 131 patients with malignant non-Hodgkin's lymphomas (107 lymphocytic lymphomas, 24 histiocytic lymphomas) were treated with cyclophosphamide-vincristin-prednisone (CVP) either alone or combined with Adriamycin (CVP-A). Stage I and II lymphocytic lymphomas were all treated by CVP combined with radiotherapy. The survival curve for this group of patients plateaued at 89% from the 12th to the 60th month, which was the endpoint of the study. For Stage III and IV nodular lymphocytic lymphomas, actuarial survival was 69% at five years in the CVP-treated group as compared to 54% at three years in the group treated with CVP-A. For Stage III and IV diffuse lymphocytic lymphomas, the complete response rate and median survival were respectively 25% and 24 months in patients treated with CVP, as compared to 67% (P less than 0.01) and 26 months in the group treated with CVP-A. For histiocytic lymphomas, the complete response rate was 50% in the CVP-treated group as compared to 83% in the group treated with CVP-A. Most remarkable was the fact that while in the CVP treated group median survival was only 17 months, the small group of patients treated with CVP-A exhibited considerably improved survival with a horizontal survival curve at 90% after 36 months (12 patients). These results show that the CVP protocol remains an excellent treatment for nodular lymphocytic lymphomas. The addition of Adriamycin (CVP-A) as well as its inclusion in other drugs combination, has raised hopes for remissions of long duration and even for cures in patients with histiocytic lymphomas. Finally, in diffuse lymphocytic lymphomas, efforts will have to be pursued to improve the prognosis which remains poor despite the increased complete response rate achieved by the addition of Adriamycin.
1973年1月至1979年1月期间，131例恶性非霍奇金淋巴瘤患者（107例淋巴细胞性淋巴瘤，24例组织细胞性淋巴瘤）接受了环磷酰胺-长春新碱-泼尼松（CVP）单药治疗或联合阿霉素（CVP-A）治疗。Ⅰ期和Ⅱ期淋巴细胞性淋巴瘤均采用CVP联合放疗。该组患者的生存曲线在第12个月至第60个月（研究终点）时稳定在89%。对于Ⅲ期和Ⅳ期结节性淋巴细胞性淋巴瘤，CVP治疗组的5年精算生存率为69%，而CVP-A治疗组的3年精算生存率为54%。对于Ⅲ期和Ⅳ期弥漫性淋巴细胞性淋巴瘤，CVP治疗患者的完全缓解率和中位生存期分别为25%和24个月，而CVP-A治疗组分别为67%（P<0.01）和26个月。对于组织细胞性淋巴瘤，CVP治疗组的完全缓解率为50%，而CVP-A治疗组为83%。最显著的是，在CVP治疗组中，中位生存期仅为17个月，而接受CVP-A治疗的一小部分患者生存期有显著改善，36个月后生存曲线水平维持在90%（12例患者）。这些结果表明，CVP方案仍然是结节性淋巴细胞性淋巴瘤的一种优秀治疗方法。添加阿霉素（CVP-A）以及将其纳入其他药物组合，为组织细胞性淋巴瘤患者实现长期缓解甚至治愈带来了希望。最后，对于弥漫性淋巴细胞性淋巴瘤，尽管添加阿霉素提高了完全缓解率，但仍需努力改善其预后，目前预后仍然很差。
