The management of early-stage aggressive non-Hodgkin's lymphoma

Sixty-one patients with stage I or II non-Hodgkin's lymphoma of aggressive histological subtype were treated at the Royal Marsden Hospital between 1972 and 1984. The overall 5-year survival probability was 69 per cent (60 per cent continuously relapse-free). The 5-year survival probability was 80 per cent for stage I disease and 55 per cent in stage II (p = 0.05). Survival was significantly higher in non-bulky than bulky presentations (85 per cent versus 44 per cent at 5 years, p = 0.003). There was no significant 2-year survival difference between those treated initially with chemotherapy and those treated with radiotherapy alone (65 per cent versus 83 per cent), however chemotherapy had been employed predominantly in patients with adverse presentations. The 2-year survival in 41 patients treated initially with doxorubicin-containing chemotherapy combinations was 76 per cent. Combined modality treatments should be considered especially in patients with stage II or bulky disease.