ISSN:
1569-8041
Keywords:
conservative treatment
;
gastric lymphoma
;
non-Hodgkin's lymphoma
Source:
Springer Online Journal Archives 1860-2000
Topics:
Medicine
Notes:
Abstract Background: We aimed to evaluate the safety and effectiveness of aconservative approach with short-term chemotherapy with or withoutconsolidation radiotherapy in primary resectable large-cell gastric lymphomain patients not requiring emergency surgery at presentation. Patients and methods: Seventeen consecutive patients presenting withresectable primary large-cell lymphoma of the stomach not requiring immediatesurgery were initially treated with chemotherapy with or without consolidationradiotherapy. Subtotal or total resection of the stomach was planned only assalvage treatment for those patients who failed locally, or as emergencysurgery in instances of acute iatrogenic complications of treatment.Chemotherapy included four to six cycles of an anthracycline-containingregimen, and consolidation radiotherapy was planned on the entire stomach andsurrounding lymph node areas for complete responders readily capable ofcompliance with a daily treatment schedule at our Institution. Results: None of the patients in the present series experienced acuteiatrogenic morbidity or mortality from local complications. After a medianfollow-up of almost six years, two patients failing first-line chemotherapyhave died of progressive lymphoma, while 15 patients are well and currentlydisease-free. Conclusions: Up-front chemotherapy as initial treatment for primary gastriclarge-cell lymphoma appears to be a safe and effective treatment by which mostpatients can probably be spared surgical gastrectomy. Consolidation radiationtherapy on the stomach can probably improve on the effectiveness ofchemotherapy alone. More experience is needed to elucidate the prognosticfactors, treatment-related long-term toxic effects and the feasibility of sucha treatment administered outside of highly specialized institutions.
Type of Medium:
Electronic Resource
URL:
http://dx.doi.org/10.1023/A:1008206329583
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