Predictive value of the early response to chemotherapy in high-risk stages II and III XXXX .

@entity1 @entity4174 @entity1568 @entity229 @entity358 @entity1891 @entity3700 @entity978
A series of 60 @entity1 with "high risk" @entity978 (B symptoms, or large mediastinal mass, or @entity358 ) were staged without laparotomy and treated with combined modality treatment: @entity3700 , @entity1891 , @entity4174 , and @entity229 (6 MOPP) plus radiotherapy. @entity1 were restaged after the first three courses of MOPP and the status of response to therapy at that time was called early response to chemotherapy (ERC). The rate of @entity1568 mustard and @entity4174 delivery (MRD) during the first three cycles of chemotherapy also was assessed. At the completion of the therapy @entity1 were restaged and the final response was assessed. Fifty-two (86.7%) @entity1 entered complete remission (CR). Forty-eight percent of the complete responders achieved CR in the first three courses of MOPP. Eight-year survival and disease-free survival (DFS) rates of the @entity1 achieving CR were 71% and 73%, respectively. Survival and DFS were significantly better for the @entity1 who achieved CR in the first three cycles of chemotherapy than for @entity1 who entered CR at a later stage of therapy: 8-year survival 90% versus 55% (P = 0.00); 8-year DFS 87% versus 59% (P = 0.01). The attainment of a complete ERC was adversely affected by lymphocyte depletion (LD) histologic type (P = 0.01) and MRD less than 65% (P = 0.04). However, when a multivariate regression analysis was used, ERC was the only significant prognostic variable for survival and DFS and its predictive value was confirmed even after correction by MRD. These data suggest that the rapidity of response to chemotherapy could be an important prognostic factor in high-risk @entity978 .
