{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T11:42:51Z","timestamp":1789558971614,"version":"build-2803163510"},"reference-count":59,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"11","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCO"],"published-print":{"date-parts":[[2003,6,1]]},"abstract":"<jats:p> Purpose: Standard therapy for patients with stage I\u2013II indolent lymphoma has been involved-field radiation therapy (IF-XRT), which achieves 10-year disease-free survival in 40% to 50% of patients, with many of these patients cured. We investigated the potential for combined-modality therapy to increase the disease-free survival for such patients. <\/jats:p><jats:p> Patients and Methods: A total of 102 eligible patients with stage I\u2013II low grade lymphoma (International Working Formulation criteria) were enrolled from 1984 to 1992. Treatment comprised 10 cycles of risk-adapted chemotherapy (cyclophosphamide, vincristine, prednisone, bleomycin [COP-Bleo], and with doxorubicin added for some [CHOP-Bleo]) and 30 to 40 Gy IF-XRT. <\/jats:p><jats:p> Results: The patients\u2019 median age was 56 years (range, 28 to 77), with follicular histology in 83%, bulky disease (\u2265 5 cm) in 24%, and stage II in 52%. There were no treatment-related deaths and 99% of patients attained complete remission. With a median follow-up of 10 years, the 10-year time to treatment failure and overall survival were 76% and 82%, respectively. For patients with follicular lymphoma, these figures were 72% and 80%, respectively. The only factor associated with treatment failure, for follicular lymphoma patients, was stage-modified International Prognostic Factors Index score (P = .02). None of 17 patients with diffuse small lymphocytic or mucosa-associated lymphoid tissue histology have relapsed. Elevated serum beta<jats:sub>2<\/jats:sub>-microglobulin was associated with shorter survival (P &lt; .0001). The 10-year survival after relapse was 46%. There have been two cases of myelodysplasia and 12 other new malignancies, including four arising within radiation fields. <\/jats:p><jats:p> Conclusion: With prolonged follow-up, combined-modality therapy with risk-adapted COP-\/CHOP-Bleo and IF radiation has attained higher rates of disease control and survival than previously reported with IF-XRT alone. This apparent improvement is being further explored in an ongoing randomized trial. <\/jats:p>","DOI":"10.1200\/jco.2003.07.111","type":"journal-article","created":{"date-parts":[[2003,5,29]],"date-time":"2003-05-29T02:05:58Z","timestamp":1054173958000},"page":"2115-2122","source":"Crossref","is-referenced-by-count":111,"title":["Long-Term Follow-Up of a Prospective Study of Combined Modality Therapy for Stage I\u2013II Indolent Non-Hodgkin\u2019s Lymphoma"],"prefix":"10.1200","volume":"21","author":[{"given":"John F.","family":"Seymour","sequence":"first","affiliation":[{"name":"From the Department of Haematology, The Peter MacCallum Cancer Institute, East Melbourne, Victoria, Australia; Departments of Lymphoma\/Myeloma, Radiation Oncology, Hematopathology, and Biostatistics, The University of Texas, M.D. Anderson Cancer Center, Houston, TX."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara","family":"Pro","sequence":"additional","affiliation":[{"name":"From the Department of Haematology, The Peter MacCallum Cancer Institute, East Melbourne, Victoria, Australia; 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