Stage I-IIE primary @entity1893 of the XXXX : results of a prospective trial by the GOELAMS Study Group.

@entity1 @entity632 @entity7324 @entity706 @entity4349 @entity326 @entity229 @entity1259 @entity786 @entity4812 @entity880 @entity1732 @entity1062 @entity1893 @entity1891 @entity1349
Sixteen @entity1 with aggressive primary testicular involvement were analyzed separately from a prospective multicenter series of 494 @entity1 with stage I/II aggressive @entity706 . The treatment strategy included 3 cycles of @entity4349 -based chemotherapy followed by regional radiation therapy on inguinal, iliac, and para-aortic lymph nodes and central nervous system (CNS) prophylaxis by intrathecal chemotherapy and brain irradiation. Chemotherapy was stratified by age group. @entity1 aged 18-60 years received the Groupe Ouest Est d'Etude des Leucemies Aigues et Maladies du Sang (GOELAMS) 02 protocol: 3 monthly cycles of VCAP ( @entity7324 3 mg/m2 day 1, @entity632 80 mg/m2 day 2, @entity786 1500 mg/m2 day 2, and @entity229 80 mg/m2 days 1-5). @entity1 aged 61-75 years received the GOELAMS 03 protocol: 3 monthly cycles of VECP-Bleo ( @entity7324 3 mg/m2 day 1, @entity1259 60 mg/m2 day 1, @entity786 750 mg/m2 day 1, @entity229 50 mg/m2 days 1-7, and @entity1732 10 mg/m2 days 1 and 5). Sixteen @entity1 had testicular involvement (3.3%). Median age was 62 years (range, 29-73 years). The histological subtypes were @entity4812 in all cases. Ann Arbor stage was IEA in 11 @entity1 , IEB in 3 @entity1 , and IIEA in 2 @entity1 . All @entity1 achieved a complete response. One @entity1 died from @entity326 during the last course of chemotherapy. After a median follow-up period of 73.5 months, the probability of disease-free survival (DFS) and @entity1349 ( @entity1349 ) were 70% and 65%, respectively for all @entity1 . @entity1349 were 66% and 83% in @entity1 = 60 years of age, and 74% and 56% in @entity1 > 60 years of age. Relapse occurred in extranodal sites in 4 cases and in abdominal lymph nodes in the last case. Relapse in the CNS occurred in only 1 @entity1 and in the contralateral @entity1062 in 1 @entity1 . We found no correlation between @entity1349 , DFS and extent of testicular involvement, Ann Arbor stage, International Prognostic Index score, or @entity880 dehydrogenase level. This is the first report of a prospective study in which treatment of @entity1893 was precisely defined at diagnosis. Compared to other series, a combination of orchiectomy with 3 cycles of CHOP ( @entity786 / @entity632 / @entity1891 / @entity229 )-derived chemotherapy, regional radiation therapy, and CNS prophylaxis seems to improve prognosis. The improvement in prognosis seemed to be due in part to irradiation, including the pelvic and lomboaortic lymphatic areas, and in part to CNS prophylaxis.
