Chemotherapy followed by consolidation radiation therapy for the treatment of clinical stage ii aggressive histologic type non‐hodgkin's lymphoma

Sixty‐three eligible patients with Ann Arbor clinical Stage II or IIE aggressive histologic type non‐Hodgkin's lymphomas received combination chemotherapy (cyclophosphamide, doxorubicin, vincristine, and prednisone [COPA]) as the primary treatment technique. Moderate‐dose radiation therapy (2500 to 3000 cGy in 2 to 3 weeks) was given to anatomic areas involved initially by lymphoma in patients demonstrated to be in complete remission after chemotherapy. Fifty‐seven percent of the patients were free of lymphoma clinically after induction chemotherapy. The minimum patient follow‐up from the start of chemotherapy is 3.7 years, and the median follow‐up for patients still alive is 4.7 years. The progression‐free survival is projected to be 62% at 4 years, and 86% of the patients achieving a complete response are projected to be in continuous remission at 4 years from the completion of all therapy. There were no treatment‐related fatalities. This treatment sequence has produced durable tumor control in the majority of patients with acceptable toxicity. The need for consolidation radiation therapy is being studied currently in a controlled clinical trial.