A randomized trial of combined modality therapy of childhood non‐Hodgkin's lymphoma

Abstract

From 1975 to 1978, 69 children with non‐Hodgkin's lymphoma were staged and treated in a randomized protocol to determine the contribution of involved‐field radiotherapy (IF‐RT) to an effective drug regimen in Stages III‐IV and the efficacy of prophylactic treatment of the central nervous system with cranial irradiation and intrathecal methotrexate in Stages II‐IV. Induction therapy for Stages I‐II was vincristine, prednisone, cyclophosphamide and IF‐RT (3000–3500 rad). Stages III‐IV received the same three drugs plus adriamycin, and were randomized to receive or not receive IF‐RT. The complete remission rate was 88%. After randomization to receive CNS prophylaxis or not, all children received oral mercaptopurine and methotrexate for 18 months. The two‐year actuarial estimate of disease‐free survival for all responders is 55% and is significantly influenced by stage. (Ninety percent disease‐free survival for Stages I‐II, versus 38.8% for III‐IV, P