In a nutshell
This study investigated the safety and effectiveness of systemic chemotherapy after radiotherapy for early-stage follicular lymphoma. This study concluded that this combined treatment is more effective than radiotherapy alone for early-stage follicular lymphoma.
Some background
Radiotherapy can help control local disease in more than 90% of patients with early-stage (stage 1 – 2) follicular lymphoma. It is a potentially curative treatment, with few side effects. However, relapse often occurs in areas that did not receive radiation.
Radiotherapy followed by chemotherapy has shown promising results in patients with early-stage Hodgkin’s lymphoma. This type of treatment is called combined modality therapy (CMT). Whether CMT is safe and effective for patients with early-stage follicular lymphoma remains under investigation.
Methods & findings
This study involved 150 patients with early-stage follicular lymphoma. Patients had stage 1 (75%) or stage 2 (24.7%) disease. Patients received either radiotherapy only (50%) or R-CVP (rituximab, cyclophosphamide, vincristine, prednisolone; 50%) after radiotherapy. The average follow-up period was 9.6 years.
Ten-year progression-free survival (patients alive without a return of disease) was significantly higher in patients who received R-CVP (59%) than those who did not (41%). R-CVP was associated with a 74% reduced risk of disease progression compared to radiotherapy alone.
Ten-year overall survival (patients still alive 10 years later) was 86% (radiotherapy only) and 95% (R-CVP). Significantly more patients in the radiotherapy-only group developed aggressive disease (9.33%) versus those who also received R-CVP (2.67%).
Most of the side effects reported by radiotherapy-treated patients were mild. However, 2% of patients reported severe or life-threatening inflammation of the mucous membranes. 23.3% of patients treated with R-CVP reported severe or life-threatening side effects. Of these, the most common included low white blood cell count (14%), infection (12%), and low white blood cell count with fever (4%).
The bottom line
This study concluded that chemotherapy given after radiotherapy can significantly improve survival outcomes for patients with early-stage follicular lymphoma.
The fine print
More modern regimens are being chosen instead of R-CVP at some treatment centers, such as RB (rituximab, bendamustine).
Published By :
Journal of clinical oncology
Date :
Jul 05, 2018
