Brief chemotherapy, Stanford V, and adjuvant radiotherapy for bulky or advanced-stage XXXX : a preliminary report.

@entity1 @entity632 @entity249 @entity137 @entity3700 @entity66 @entity3018 @entity5 @entity229 @entity1161 @entity2879 @entity854 @entity1891 @entity1732 @entity978 @entity204 @entity5713
PURPOSE: Although survival rates have improved for @entity1 with bulky and advanced-stage @entity978 ( @entity978 ), current treatments entail substantial acute morbidity and risks for late effects such as @entity249 , second @entity5 , and @entity137 . A novel, brief chemotherapy regimen ( @entity632 , @entity5713 , @entity3700 , @entity1891 , @entity1732 , @entity2879 , and @entity229 [Stanford V]) was designed to shorten the duration of treatment, significantly reduce cumulative doses of alkylating agents, @entity632 , and @entity1732 , and maintain dose-intensity (DI). This brief chemotherapy was combined with @entity1161 ( @entity1161 ) to bulky disease sites. METHODS: Since May 1989, 65 previously untreated @entity1 were treated for stage II @entity978 with bulky mediastinal involvement (n = 21) or for stage III or IV @entity978 (n = 44). @entity1 received weekly chemotherapy for 12 weeks. Consolidative @entity1161 was given to the first 25 @entity1 to sites of @entity66 or @entity854 that persisted after chemotherapy; in the remaining 40 @entity1 , @entity1161 was limited to bulky disease ( @entity3018 > or = 5 cm and/or macroscopic splenic nodules defined by computed tomography [CT]). RESULTS: With a median follow-up period of 2 years, actuarial 3-year survival rate is 96% and failure-free survival (FFS) rate is 87%. The 3-year FFS rate is 100% for stage II @entity1 with bulky mediastinal disease and 82% for @entity1 with stage III to IV disease. There were no treatment-related @entity204 . In a preliminary analysis on a subset of @entity1 , female and male fertility appears to be preserved. CONCLUSION: These preliminary results indicate that the Stanford V chemotherapy regimen with or without @entity1161 is well-tolerated and effective therapy for bulky, limited-stage, and advanced-stage @entity978 . Less cumulative exposure to alkylating agents, @entity632 , and @entity1732 and limited use of radiation is expected to decrease risks for second @entity5 and late cardiopulmonary @entity137 . Based on these results, the Stanford V chemotherapy with or without @entity1161 regimen deserves further study in the context of a randomized clinical trial.
