Annals of Oncology Advance Access originally published online on January 30, 2006
Annals of Oncology 2006 17(4):676-682; doi:10.1093/annonc/mdl002
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
© 2006 European Society for Medical Oncology
The role of dose size in a chemotherapy regimen (ProMECE-CytaBOM) for the first-line treatment of large B-cell lymphomas: a randomized trial by the Gruppo Italiano Studio Linfomi (GISL)
1 Medicina Interna, Oncologia e Gastroenterologia, Università di Pavia, IRCCS Policlinico S. Matteo, Pavia; 2 Sez. di Oncologia, Università di Modena e Reggio E., Policlinico di Modena; 3 Dip. di Oncologia, Ospedale S. Spirito, Pescara; 4 Serv. di Ematologia, Arcispedale ‘S. Maria Nuova’, Reggio Emilia; 5 Serv. di Ematologia, Div. di Medicina, Ospedale ‘Miulli’, Acquaviva delle Fonti (BA); 6 Div. di Ematologia, Ospedale ‘S. Nicola Pellegrino’, Trani (BA); 7 Div. di Medicina, Ospedale di Viareggio (PI); 8 Sez. di Ematologia, Medina I, Ospedale Maggiore, Lodi, Italy
* Correspondence to: Prof. P. G. Gobbi, Medicina Interna, Oncologia e Gastroenterologia, Università di Pavia, IRCCS Policlinico S. Matteo, P.le Golgi n° 2, 27100 Pavia, Italy. (Tel: 0039–0382–502954; fax: 0039–0382–526223; E-mail: gobbipg{at}smatteo.pv.it
Background: It is still unclear the actual contribute of dose intensity (DI), dose size (DS) and dose density (DD) in the conventional chemotherapy of large, B-cell non-Hodgkin lymphomas.
Methods: A prospective, randomized trial compared the cyclic schedule of ProMECE-CytaBOM chemotherapy (cyc-PC, 6 cycles) with a modified version of it, which administered the same drugs sequentially (seq-PC), with the same planned cumulative DI and an 83% DD, within the same time frame (113 days), but with three times higher DS of all the drugs except vincristine.
Results: Fifty-six patients received cyc-PC and 52 seq-PC. The actual mean cumulative DI was 0.79 ± 0.15 with cyc-PC, 0.78 ± 0.17 with seq-PC. Response was complete in 59% and 52%, partial in 20% and 21%, null in 5% and 6%, respectively. There were four toxic deaths (two per arm). Relapses occurred in 36% and 37%, respectively. Toxicity was similar in both arms. Overall, failure-free, progression-free and disease-free survival (median follow-up: 54 months) were statistically indifferent.
Conclusions: The very similar DI actually delivered in both arm seems to be the main common determinant of the indifferent results recorded. Increasing DS – at least within the limits clinically attainable without stem cell rescue – does not improve results.
Key words: chemotherapy, large B-cell lymphoma, dose intensity, dose size, dose density
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  A. Bari, L. Marcheselli, S. Sacchi, R. Marcheselli, S. Pozzi, P. Ferri, E. Balleari, P. Musto, S. Neri, M. A. Aloe Spiriti, et al. Prognostic models for diffuse large B-cell lymphoma in the rituximab era: a never-ending story Ann. Onc., November 17, 2009; (2009) mdp531v1. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Sacchi, L. Marcheselli, A. Bari, R. Marcheselli, S. Pozzi, P. G. Gobbi, F. Angrilli, M. Brugiatelli, P. Musto, and M. Federico Second malignancies after treatment of diffuse large B-cell non-Hodgkin's lymphoma: a GISL cohort study Haematologica, September 1, 2008; 93(9): 1335 - 1342. [Abstract] [Full Text] [PDF]
|
|