[Results of a cooperative prospective study of treatment of primary digestive localizations of non-Hodgkin's lymphoma]. / Résultats d'une étude prospective et coopérative pour le traitement des localisations digestives initiales des lymphomes non Hodgkiniens.

ABSTRACT

We report the results of chemotherapy treatment in 82 patients presenting with primary digestive lymphoma and included in a study conducted between October 1977 and October 1985. There were 31 gastric lymphoma, 18 small intestinal lymphomas, and 19 with multiple involvement 63 patients had had a surgical staging with total tumor resection in 15 cases. Nineteen patients with limited disease (ID and IID) were randomly assigned to either a 3-week chemotherapy regimen associated with whole abdominal radiotherapy or chemotherapy for 3 years. Twenty-seven stage IIID and thirty-six stage IV were treated with chemotherapy alone for 3 years. Low grade lymphomas (16 patients) received a cyclophosphamide, vincristine, prednisone association. Intermediate (56 patients) and high grade (10 patients) lymphomas received cyclophosphamide, vincristine, adriamycin, prednisone. The overall complete remission obtained was 63 p. 100 (51 patients) with 17 patients in relapse within 6 to 40 months. Overall survival was 46 p. 100 at 5 years. Survival was dependent on abdominal extension, histologic grade according to the new working formulation used for lymph-node lymphomas, initial localization (gastric lymphomas have the best survival) and achievement of complete remission. Chemotherapy is an effective treatment for primary digestive lymphomas. The role of surgery in the management of lymphomas has to be defined by further studies.