Chemotherapy for the treatment of patients with primary high grade gastricB-cell lymphoma of modified Ann Arbor Stages IE and IIE

BACKGROUND. Surgical intervention and combined modality treatment including radiation and chemotherapy have been studied widely in patients with high grade gastric B-cell lymphoma, whereas to the authors' knowledge the role o f chemotherapy alone in patients with localized disease has not been invest igated extensively. METHODS. Twenty-five consecutive patients with primary high grade gastric B -cell lymphoma of localized modifed Ann Arbor Stages IE and IIE were studie d prospectively at the study institution. Patients age < 75 years (n = 17; age range, 41-75 years) were given a standard regimen comprised of doxorubi cin, cyclophosphamide, vincristine, and prednisone (CHOP), whereas patients age > 75 years (n = 8; age range, 82-93 years) were treated at a reduced d ose. Restaging was performed after 3 and 6 cycles, followed by every 3 mont hs for the first 2 years, and every 6 months thereafter. RESULTS. A total of 123 cycles were administered to the study patients, wit h the median number of 6 cycles per patient (range, 1-9 cycles). At a media n follow-up of 24 months (range, 1.5-87+ months), 22 patients were alive wi thout evidence of disease and 3 patients had died (1 patient death was trea tment-related). Twenty-four patients who were considered evaluable achieved a complete remission, 21 patients after 3 cycles and the remaining 3 patie nts after 6 cycles of treatment. Side effects generally were manageable, wi th only one patient requiring premature discontinuation of treatment due to protracted thrombocytopenia after three courses of therapy, and tolerance was not different between the two age groups. No recurrences were observed at last follow-up. CONCLUSIONS. The authors believe that chemotherapy using the CHOP regimen i s highly effective in the treatment of patients with localized primary high grade gastric lymphoma. (C) 2000 American Cancer Society.