Treatment Results in Localized Primary Gastric Lymphoma: Data of Patients Registered Within the German Multicenter Study (GIT NHL 02/96)

In the prospective study 02/96 on primary GI lymphoma, we have collected data on histology, clinical features, and treatment results. In particular, in stages I and II localized primary gastric lymphoma (PGL), our objectives were to reduce treatment intensity and to confirm our hypothesis from study...

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Bibliographic Details
Published in:	Journal of clinical oncology Vol. 23; no. 28; pp. 7050 - 7059
Main Authors:	KOCH, Peter, PROBST, Andreas, BREITSPRECHER, Regine, SCHMITS, Rudolf, FREUND, Mathias, FIETKAU, Rainer, KETTERER, Peter, FREITAG, Eva-Maria, HINKELBEIN, Margit, HEMECKE, Achim, PARWARESCH, Reza, TIEMANN, Markus, BERDEL, Wolfgang E, WILLICH, Normann A, REINARTZ, Gabriele, BROCKMANN, Jens, LIERSCH, Rudiger, DEL VALLE, Francisco, CLASEN, Hermann, HIRT, Carsten
Format:	Journal Article
Language:	English
Published:	Baltimore, MD American Society of Clinical Oncology 01-10-2005 Lippincott Williams & Wilkins
Subjects:	Adult Aged Aged, 80 and over Antineoplastic Combined Chemotherapy Protocols - administration & dosage Antineoplastic Combined Chemotherapy Protocols - therapeutic use Biological and medical sciences Combined Modality Therapy Cyclophosphamide - administration & dosage Dose Fractionation Doxorubicin - administration & dosage Female Hematologic and hematopoietic diseases Humans Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis Lymphoma - drug therapy Lymphoma - pathology Lymphoma - radiotherapy Lymphoma - surgery Male Medical sciences Middle Aged Neoplasm Staging Prednisone - administration & dosage Prospective Studies Stomach Neoplasms - drug therapy Stomach Neoplasms - pathology Stomach Neoplasms - radiotherapy Stomach Neoplasms - surgery Survival Analysis Treatment Outcome Tumors Vincristine - administration & dosage Europe Germany Human Stomach Cancerology Treatment Digestive system Register Lymphoproliferative syndrome Multicenter study Primary Malignant hemopathy Non Hodgkin lymphoma Localized
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Summary:	In the prospective study 02/96 on primary GI lymphoma, we have collected data on histology, clinical features, and treatment results. In particular, in stages I and II localized primary gastric lymphoma (PGL), our objectives were to reduce treatment intensity and to confirm our hypothesis from study 01/92, which maintained that an organ-preserving approach is not inferior to primary surgery. Patients receiving radiotherapy and/or chemotherapy were stratified for histologic grade, stage, and whether surgery had been carried out or not (as decided by each participating center). Patients with aggressive PGL received six cycles of CHOP-14 (cyclophosphamide, doxorubicin, vincristine, and prednisone) followed by involved-field radiotherapy (40 Gy). Patients with indolent PGL (including patients experiencing treatment failure with antibiotic therapy for Helicobacter pylori) were treated with extended-field radiotherapy. The volume depended on stage. The irradiation dose was 30 Gy, followed by a boost of 10 Gy (the latter omitted after complete resection) to the tumor region. Seven hundred forty-seven patients were accrued. Of these patients, 393 with localized PGL were treated with radiotherapy and/or chemotherapy only or additional surgery between December 1996 and December 2003. The survival rate at 42 months for patients treated with surgery was 86% compared with 91.0% for patients without surgery. In this nonrandomized study (02/96), we reproduced the previous results of study 01/92 showing no disadvantage for an organ-preserving treatment. Therefore, primary stomach resection should be questioned.
ISSN:	0732-183X 1527-7755
DOI:	10.1200/JCO.2005.04.031