According to an article recently published in the Journal of Clinical Oncology, the addition of radiation therapy to chemotherapy does not appear to improve outcomes among elderly patients with aggressive non-Hodgkin’s lymphoma who have a favorable prognosis.

Non-Hodgkin’s lymphoma (NHL) is a form of cancer that begins in the cells of the lymph system, which includes the spleen, thymus, tonsils, bone marrow, lymph nodes, and circulating immune cells. Lymphocytes are the main cells in the lymph system and exist in two forms: B- and T-cells. Each of these cells serves a specific function in aiding the body fight infection.

Chemotherapy including CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone) plus radiation remains a standard approach for treatment of NHL that is not considered advanced but is aggressive in nature. Researchers continue to evaluate ways to minimize side effects caused by treatment while maintaining optimal outcomes. For some types of NHL, radiation therapy is being utilized less frequently because it increases side effects and does not appear to be an essential component of treatment. Researchers continue to evaluate which specific types of NHL and which patients benefit most from radiation therapy.

Researchers from Europe recently conducted a clinical trial to further evaluate the addition of radiation therapy to CHOP in the treatment of NHL. This trial included 576 patients who were 60 years or older, had been diagnosed with aggressive NHL but had a favorable prognosis, and had not received prior therapy. One group of patients was treated with CHOP plus radiation therapy, and the other was treated with CHOP alone.

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  • Overall survival at five years was 72% for those treated with CHOP alone and 68% for those treated with CHOP plus radiation therapy.
  • At five years event-free survival (no disease progression or death) was 61% for those treated with CHOP alone and 64% for those treated with CHOP plus radiation therapy.

The researchers concluded that the addition of radiation therapy to CHOP did not improve outcomes for patients over 60 years of age with aggressive NHL that was not considered advanced. Patients diagnosed with NHL may wish to speak with their physician regarding their individual risks and benefits of all treatment options.

Reference: Bonnet C, Fillet G, Mounier N, et al. CHOP alone compared with CHOP plus radiotherapy for localized aggressive lymphoma in elderly patients: a study by the Group d’Etude des Lymphomes de l’Adulte. Journal of Clinical Oncology. 2007; 25:787-792.

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