TY - JOUR
T1 - Prognostic factors of stage I and II non-hodgkin's lymphomas of the head and neck
T2 - the value of the working formulation and need for chemotherapy
AU - Shigematsu, Naoyuki
AU - Kondo, Makoto
AU - Mikata, Atsuo
PY - 1988/11
Y1 - 1988/11
N2 - From 1966 through 1984, 142 patients with early stage non-Hodgkin's lymphoma of the head and neck were treated. Histologic slides were reviewed and reclassified according to Rappaport's classification and the Working Formulation. Patients were clinically staged; 82 Stage I, and 60 Stage II. Five-year freedom from relapse was 53% for Stage I and 48% for Stage 11 patients with no statistically significant difference. No patients with favorable histologies of Rappaport's classification or low grade malignancy of the Working Formulation relapsed. By univariate analyses, stage, primary site, the Working Formulation, Rappaport's classification, extent of radiation field, radiation dose, tumor bulkiness and addition of multiple-agent chemotherapy seemed to be prognostic factors for predicting relapse. Multivariate regression analyses (MVA) showed primary site and multiple-agent chemotherapy were independent prognostic factors. Tumor bulkiness provided marginal prognostic significance. Waldeyer's ring lymphomas fared better than nodal or extralymphatic lymphomas; it seems necessary to report Waldeyer's ring lymphomas independently from nodal or extralymphatic lymphomas. Patients receiving more than 3 chemotherapeutic agents had better prognosis than those receiving 3 or less agents, or no chemotherapy. Pathologic grade was another prognostic factor when the Working Formulation was used in MVA. When Rappaport's classification was used, division of unfavorable histologies into histiocytic and non-histiocytic groups provided only marginal significance in MVA. We conclude that Stage I-II non-Hodgkin's lymphomas of the head and neck with favorable histologies of Rappaport's classification or low grade malignancy of the Working Formulation be treated with radiation therapy only; and patients with other histologies should be treated with multiple-agent chemotherapy and radiation therapy.
AB - From 1966 through 1984, 142 patients with early stage non-Hodgkin's lymphoma of the head and neck were treated. Histologic slides were reviewed and reclassified according to Rappaport's classification and the Working Formulation. Patients were clinically staged; 82 Stage I, and 60 Stage II. Five-year freedom from relapse was 53% for Stage I and 48% for Stage 11 patients with no statistically significant difference. No patients with favorable histologies of Rappaport's classification or low grade malignancy of the Working Formulation relapsed. By univariate analyses, stage, primary site, the Working Formulation, Rappaport's classification, extent of radiation field, radiation dose, tumor bulkiness and addition of multiple-agent chemotherapy seemed to be prognostic factors for predicting relapse. Multivariate regression analyses (MVA) showed primary site and multiple-agent chemotherapy were independent prognostic factors. Tumor bulkiness provided marginal prognostic significance. Waldeyer's ring lymphomas fared better than nodal or extralymphatic lymphomas; it seems necessary to report Waldeyer's ring lymphomas independently from nodal or extralymphatic lymphomas. Patients receiving more than 3 chemotherapeutic agents had better prognosis than those receiving 3 or less agents, or no chemotherapy. Pathologic grade was another prognostic factor when the Working Formulation was used in MVA. When Rappaport's classification was used, division of unfavorable histologies into histiocytic and non-histiocytic groups provided only marginal significance in MVA. We conclude that Stage I-II non-Hodgkin's lymphomas of the head and neck with favorable histologies of Rappaport's classification or low grade malignancy of the Working Formulation be treated with radiation therapy only; and patients with other histologies should be treated with multiple-agent chemotherapy and radiation therapy.
KW - Chemotherapy
KW - Head and neck non-Hodgkin's lymphoma
KW - Radiotherapy
KW - Rappaport's classification
KW - The Working Formulation
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U2 - 10.1016/0360-3016(88)90192-7
DO - 10.1016/0360-3016(88)90192-7
M3 - Article
C2 - 3182343
AN - SCOPUS:0023804269
VL - 15
SP - 1111
EP - 1118
JO - International Journal of Radiation Oncology Biology Physics
JF - International Journal of Radiation Oncology Biology Physics
SN - 0360-3016
IS - 5
ER -