Lymphoma Clinical Trial
Official title:
A Phase III Study of Involved Field Radiation Therapy (IFRT) in Patients With Histologically Aggressive Non-Hodgkin's Lymphoma Following High Dose Chemotherapy and Autologous Hematopoietic Stem Cell Transplantation (ASCT)
RATIONALE: Radiation therapy uses high-energy x-rays to damage tumor cells. It is not yet
known if giving radiation therapy after stem cell transplantation is more effective than stem
cell transplantation alone in treating relapsed or refractory non-Hodgkin's lymphoma.
PURPOSE: Randomized phase III trial to determine the effectiveness of radiation therapy in
treating patients who have relapsed or refractory non-Hodgkin's lymphoma and have undergone
autologous stem cell transplantation.
OBJECTIVES:
- Compare the 3-year progression-free survival of patients with relapsed or refractory
aggressive non-Hodgkin's lymphoma treated with high-dose chemotherapy and autologous
hematopoietic stem cell transplantation with or without involved-field radiotherapy.
- Compare the overall survival of patients treated with these regimens.
- Compare 3-year progression-free disease within and outside radiotherapy fields in
patients treated with these regimens.
- Compare quality of life of patients treated with these regimens.
- Compare the toxic effects of these regimens in these patients.
OUTLINE: This is a randomized, multicenter study. Patients are stratified according to
response to pre-salvage chemotherapy (primary refractory disease vs relapse), response to
post-salvage chemotherapy (complete/unconfirmed complete vs partial), and participating
center. Within 6-8 weeks after completion of autologous hematopoietic stem cell
transplantation, patients are randomized to 1 of 2 treatment arms.
- Arm I: Patients undergo involved-field radiotherapy (IFRT) 5 days a week for 3-5 weeks
in the absence of unacceptable toxicity.
- Arm II: Patients undergo observation only. Quality of life in arm I is assessed at
baseline, on day 1 of IFRT, at weeks 2 and 4 during IFRT, at 1 month, 4 months, every 3
months for 2 years, every 6 months for 1 year, and then annually for 2 years. Quality of
life in arm II is assessed at baseline, 1 month, 2 months, every 3 months for 2 years,
every 6 months for 1 year, and then annually for 2 years.
Patients are followed at 1 month, every 3 months for 2 years, every 6 months for 1 year, and
then annually for 2 years.
PROJECTED ACCRUAL: A total of 230 patients (115 per treatment arm) will be accrued for this
study within 4.2 years.
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