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Adding six cycles of drug treatment after radiotherapy for early follicular lymphoma cut relapses outside the treated area and improved ten-year freedom from progression from 41 to 59 per cent.
A multicentre randomised controlled trial enrolling patients with stage I to II low-grade follicular lymphoma after computed tomography staging and bone marrow biopsy; positron emission tomography was not mandatory. Patients were randomised to 30 Gy of involved-field radiotherapy alone, or the same radiotherapy followed by six cycles of cyclophosphamide, vincristine and prednisolone. From 2006 rituximab was added to the systemic arm.
Between 2000 and 2012, 150 patients were enrolled, 75 per arm; of the 75 in the systemic arm, 44 received CVP and 31 R-CVP. At randomisation 75 per cent had stage I disease, median age was 57, 52 per cent were male and 48 per cent had positron emission tomography staging. At a median follow-up of 9.6 years (range 3.1 to 15.8), progression-free survival favoured the systemic arm (hazard ratio 0.57, 95 per cent confidence interval 0.34 to 0.95, p = 0.033), with ten-year rates of 59 per cent (46 to 74) against 41 per cent (30 to 57).
The evidence that early follicular lymphoma is less often confined to the radiation field than staging suggests, and that a short course of systemic treatment after radiotherapy reduces relapse. It is also the reason modern practice stages this disease with positron emission tomography.
Shares Prednisone, Vincristine, Rituximab, Lymphoma roadmap: from a jaw tumour in Uganda and the first human cancer virus to gene-expression subtypes, PET-adapted chemotherapy, CAR-T cells, bispecific antibodies and the genetics-directed trials now recruiting and the tag lymphoma-evidence.
Shares Prednisone, Vincristine, Rituximab, Lymphoma roadmap: from a jaw tumour in Uganda and the first human cancer virus to gene-expression subtypes, PET-adapted chemotherapy, CAR-T cells, bispecific antibodies and the genetics-directed trials now recruiting and the tag lymphoma-evidence.
Shares Prednisone, Vincristine, Rituximab, Lymphoma roadmap: from a jaw tumour in Uganda and the first human cancer virus to gene-expression subtypes, PET-adapted chemotherapy, CAR-T cells, bispecific antibodies and the genetics-directed trials now recruiting and the tag lymphoma-evidence.
Shares Prednisone, Vincristine, Rituximab, Lymphoma roadmap: from a jaw tumour in Uganda and the first human cancer virus to gene-expression subtypes, PET-adapted chemotherapy, CAR-T cells, bispecific antibodies and the genetics-directed trials now recruiting and the tag lymphoma-evidence.
Shares Prednisone, Vincristine, Rare and paediatric cancers without markets, Lymphoma roadmap: from a jaw tumour in Uganda and the first human cancer virus to gene-expression subtypes, PET-adapted chemotherapy, CAR-T cells, bispecific antibodies and the genetics-directed trials now recruiting and the tag lymphoma-evidence.
Shares Prednisone, Trials enrol too few, too slowly, Vincristine, Rituximab and the tag lymphoma-evidence.
Shares Trials enrol too few, too slowly, Rituximab, Rare and paediatric cancers without markets, Lymphoma roadmap: from a jaw tumour in Uganda and the first human cancer virus to gene-expression subtypes, PET-adapted chemotherapy, CAR-T cells, bispecific antibodies and the genetics-directed trials now recruiting and the tag lymphoma-evidence.
Shares Prednisone, Trials enrol too few, too slowly, Vincristine, Rituximab and the tag lymphoma-evidence.