STOMACH PRESERVATION IN LOW-GRADE AND HIGH-GRADE PRIMARY GASTRIC LYMPHOMAS - PRELIMINARY-RESULTS

Background. The optimal management of primary gastric lymphomas has ye t to be defined. In the past surgery was advocated as the optimal firs t step for patients with PGL. Recently, an increasing number of studie s suggest that chemotherapy is as effective as surgery. Methods. Fourt een patients with PGL were treated with chemotherapy alone. For patien ts with low-grade lymphoma, chemotherapy consisted of mitoxantrone 5 m g/sqm on days 1 to 3. Treatment courses were administered every 3 week s up to a maximum of 6 cycles. Patients with high-grade lymphoma recei ved chemotherapy according to the CHOP schedule every 4 weeks up to a maximum of 6 cycles. Two patients with high-grade lymphoma were treate d as low-grade lymphoma patients (one because of age and poor performa nce status, the other because she refused chemotherapy that would caus e hair loss). Two patients with low-grade lymphomas who did not respon d to mitoxantrone were crossed over to CHOP. Results. All patients wer e evaluable for toxicity, 13 for response to therapy and survival. Tox icity was mild or moderate. Neither perforation nor hemorrhage was obs erved. Eleven patients achieved a complete remission (85%), 1 a partia l remission (7.5%) and 1 underwent disease progression (7.5%). At a me dian follow-up of 12 months (range 4-44 months) all complete responder s are alive and disease free. Conclusions. Although the number of eval uable patients is too small to draw any final conclusions, chemotherap y seems to be as effective as surgery in PGL, and stomach preservation improves the quality of life of the patients.