The influence of chemotherapy on the management of non-Hodgkin's lymphomata at the Princess Margaret Hospital. A comparison of the results from 1962-64 with 1967-69.

A retrospective study of 460 non-Hodgkin's lymphoma patients seen in 1962-64 (185) and 1967-69 (275) revealed a marked improvement in the survival of patients treated during the later interval. The increased survival was not due to differences in the age or sex distribution of patients, the proportions with systemic symptoms or extranodal presentations. The improvement was due partially to a disproportionate increase in the number of patients with well- and intermediately differentiated nodular lymphocytic lymphomata in 1967-69. When these patients were removed, the proportions of patients with "good" and "poor" pathology were comparable for the two intervals, and a markedly improved survival was still evident for the 1967-69 group. An improvement in the proportion of patients achieving a complete remission occurred only in patients who received some form of chemotherapy. Relapses occurred in 44.6% of patients with Stage I and II disease treated with radiotherapy alone. The results of this study indicate that we must re-evaluate carefully the indications for radiotherapy in the treatment of the non-Hodgkin's lymphomata. The addition of chemotherapy appears to be a promising method for increasing the proportion of patients who will achieve a long complete remission.