Non-Hodgkin's lymphoma of stage I and II in elderly patients: a retrospective study in comparison with younger patients

Forty-one patients with non-hodgkin's lymphoma at stages I and II who had received radiation therapy were reviewed to analyze the prognosis and prognostic factors, with the main focus on a comparison of elderly (age > 65 years) and younger patients. In terms of clinical and histological characteristics, there were no differences between the elderly and younger patients. The 5-year-survival rate (5YS) in elderly patients was 52.8%, compared with 68.6% for younger patients. In patients treated with irradiation alone, the 5YS was 49.5% in elderly patients and 22.1% in younger patients. Combination treatment consisting of irradiation and chemotherapy improved 5YS markedly to 84.9% in the younger patients, while no apparent improvement was seen in the elderly patients, in whom 5YS was 54.1%. Using Cox's multiregression life table, two prognostic factors, the presence of symptoms and LDH, were extracted and found to have a significant influence upon the survival of the elderly patients. Complete response was 90.2% in the elderly patients, although relapse was seen in 54.1% of the complete responders. Relapse occurred overwhelmingly outside the irradiated regions. Since the prognosis of elderly patients could not be improved with the current chemotherapy regimen, some different regimen must be established to lower the high relapse rate in the area outside the irradiated field.