CHOP IS THE STANDARD REGIMEN IN PATIENTS GREATER-THAN-OR-EQUAL-TO-70 YEARS OF AGE WITH INTERMEDIATE-GRADE AND HIGH-GRADE NON-HODGKINS-LYMPHOMA - RESULTS OF A RANDOMIZED STUDY OF THE EUROPEAN ORGANIZATION FOR RESEARCH AND TREATMENT OF CANCER LYMPHOMA COOPERATIVE STUDY-GROUP

Purpose: We report the results of a randomized study of the European O rganization for Research and Treatment of Cancer (EORTC) Lymphoma Grou p, which compared a chemotherapy regimen specifically devised for elde rly patients, ie, etoposide, mitoxantrone, and prednimustine (VMP), ve rsus the standard regimen of cyclophosphamide, doxorobucin, vincristin e, and prednisone (CHOP) in patients older than 70 years of age with i ntermediate-and high-grade non-Hodgkin's lymphoma (NHL). Patients and Methods: Patients older than 70 years of age with stage II, III, or IV intermediate- and high-grade NHL, with an Eastern Cooperative Oncolog y Group (ECOG) performance status less than 4 and acceptable cardiac, renal, and liver function were randomized to receive six courses of VM P or six courses of CHOP, Between February 1989 and June 1994, 130 pat ients aged 70 to 93 years (median, 75) were enrolled and 120 were asse ssable for response, 60 patients in each arm. Results: Overall objecti ve response rates were 50% and 77% in VMP- and CHOP-treated patients, respectively (P = .01), while complete response (CR) rates were border line significant (27% v 45%; P = .06), At 2 years, the progression-fre e survival (PFS) rate was 25% with VMP versus 55% with CHOP (P = .002) and the overall survival (OS) rate was 30% with VMP versus 65% with C HOP (P = .004). Statistically significant more alopecia and neurologic and gastrointestinal toxicities were reported with CHOP. Conclusion: CHOP is the standard regimen for patients greater than or equal to yea rs of age with stage II to IV intermediate- and high-grade NHL. (C) 19 98 by American Society of Clinical Oncology.