Chemotherapy, no radiation for lymphoma type effective

Patients with a type of lymphoma who received chemotherapy but not radiation therapy to the thorax had excellent outcomes, U.S. researchers say. Dr. Wyndham Wilson of the National Cancer Institute, part of the National Institutes of Health, and colleagues conducted the trial, in which every patient received the drugs etoposide, doxorubicin, cyclophosphamide, vincristine, prednisone and rituximab. This regimen uses infusion strategies in which doses of the drugs etoposide, doxorubicin and cyclophosphamide are adjusted for greatest efficacy. Until now, most standard treatment for this type of lymphoma included radiation to the mediastinum, a part of the thorax, but it has long-term toxic side effects, Wilson said. Fifty-one patients with untreated primary mediastinal B-cell lymphoma were included in this phase II study. The maximum tumor diameter was 11 centimeters -- less than a half inch. All but two patients achieved a complete remission with chemotherapy, and none of the patients with a complete remission have developed a recurrent lymphoma. The two patients who did not achieve a complete remission received radiation and have also not had their tumors recur. There was no evidence of other diseases developing later on or cardiac toxic effects, Wilson said. The findings were published in The New England Journal of Medicine.