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Effect of prior radiotherapy on tolerance and response to chemotherapy in non‐hodgkin's lymphoma
Author(s) -
Bender Richard A.,
Johnson Bonny L.,
Norton Larry,
Young Robert C.
Publication year - 1977
Publication title -
american journal of hematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.456
H-Index - 105
eISSN - 1096-8652
pISSN - 0361-8609
DOI - 10.1002/ajh.2830020203
Subject(s) - medicine , radiation therapy , chemotherapy , bone marrow , lymphoma , non hodgkin's lymphoma , histology , oncology , surgery , gastroenterology
Twenty‐five patients who had received radiotherapy as their primary treatment for non‐Hodgkin's lymphoma subsequently relapsed; they were then treated with combination chemotherapy and their tolerance and response evaluated. Radiotherapy delivered as total body irradiation and other forms of radiotherapy delivered to > 15% of the bone marrow caused significantly lower platelet nadirs during subsequent chemotherapy when compared to patients receiving radiotherapy to ≤ 15% of their bone marrow. In spite of this thrombocytopenic effect, the eventual total doses of chemotherapy delivered were not significantly compromised. A response to chemotherapy was more likely in patients with a prolonged (> 6 months) response to radiotherapy. However, a chemotherapy response was equally likely in patients receiving involved field (IF), extended field (EF), or total nodal irradiation (TNI) as compared to those receiving total body irradiation (TBI). Chemotherapy responses (complete and partial) occurred in 75% of both radiotherapy groups with complete responses more likely in the IF, EF, or TNI group. The median durations of response were slightly longer in the IF, EF, or TNI radiotherapy group (6 months vs 5 months; p = 0.07) but were shorter than those in previously reported patients not receiving prior radiotherapy. Similarly the duration of a chemotherapy response was not affected by the histology of the tumor. However, although the survival of patients following chemotherapy was not significantly affected by the histology of the tumor there was a tendency towards a longer survival for lymphocytic histology as compared to histiocytic.