Abstract:
:Morbidity, mortality and discomfort related to gastrectomy has led some investigators to treat patients with stage I-II primary gastric high-grade lymphoma (PGL) with a conservative strategy. Here we report a retrospective series of 21 patients with PGL treated with primary chemotherapy alone or followed by radiation therapy and analyze previously reported series, focusing on therapeutic results, treatment-related morbidity and stomach preservation rate. All 21 patients with stage I-II PGL received an initial anthracycline-containing chemotherapy, which was followed by involved field-radiation therapy in 8 cases. Data regarding toxicity, response and relapse rates and survival of this patient group and 14 previously published series, involving 316 patients treated with conservative modality, were also analyzed. In the present series two patients did not complete the planned treatment, while the remaining 19 achieved a complete remission (response rate: 90%). Three patients relapsed, all of whom had been treated with chemotherapy alone. Two patients died of lymphoma, one of sepsis and the other of lung cancer while still relapse-free. The survival rate at 50 months is 81%, and the 5-year actuarial cause-specific survival is 82%. The stomach preservation rate is 100%. Previously reported series showed a response rate ranged between 76% and 100%. Gastrointestinal bleeding was observed in only 3% of cases, while no cases of gastric perforation were reported. Treatment mortality rate was 2.5%. 5-year actuarial survival ranged between 73% and 90% and stomach preservation rate was 97%. Short-term chemotherapy obtained similar results to more prolonged treatment. In conclusion, conservative treatment with primary chemotherapy followed by involved field-radiation therapy should be used for the first-line treatment of patients with stage I/II PGL considering that it is associated with a high response and survival rates, and with an insignificant risk of bleeding or perforation, high stomach preservation rate and good quality of life.
journal_name
Leuk Lymphomajournal_title
Leukemia & lymphomaauthors
Ferreri AJ,Cordio S,Ponzoni M,Villa Edoi
10.3109/10428199909058457keywords:
subject
Has Abstractpub_date
1999-05-01 00:00:00pages
531-41issue
5-6eissn
1042-8194issn
1029-2403journal_volume
33pub_type
杂志文章abstract::A prospective randomized study on aggressive non-Hodgkin's lymphomas was conducted by investigators at several Italian institutions with the intent of comparing two third-generation conceptually different regimens: the regimen containing methotrexate with leucovorin rescue, doxorubicin, cyclophosphamide, vincristine, ...
journal_title:Leukemia & lymphoma
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.3109/10428199509054434
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journal_title:Leukemia & lymphoma
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journal_title:Leukemia & lymphoma
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journal_title:Leukemia & lymphoma
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journal_title:Leukemia & lymphoma
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journal_title:Leukemia & lymphoma
pub_type: 杂志文章,多中心研究,随机对照试验
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journal_title:Leukemia & lymphoma
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journal_title:Leukemia & lymphoma
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doi:10.3109/10428199709042502
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journal_title:Leukemia & lymphoma
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doi:10.3109/10428194.2013.770151
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journal_title:Leukemia & lymphoma
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doi:10.3109/10428199509107909
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journal_title:Leukemia & lymphoma
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doi:10.3109/10428199509112208
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journal_title:Leukemia & lymphoma
pub_type: 杂志文章
doi:10.3109/10428190109064612
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pub_type: 杂志文章,评审
doi:10.3109/10428199609051752
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journal_title:Leukemia & lymphoma
pub_type: 杂志文章
doi:10.1080/10428190802064909
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doi:10.3109/10428194.2013.813500
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journal_title:Leukemia & lymphoma
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doi:10.3109/10428199909145722
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journal_title:Leukemia & lymphoma
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journal_title:Leukemia & lymphoma
pub_type: 临床试验,杂志文章
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journal_title:Leukemia & lymphoma
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journal_title:Leukemia & lymphoma
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