S0313 Cyclophosphamide, Doxorubicin, Vincristine, Prednisone, and Radiation Therapy Followed By Rituximab and Yttrium Y 90 Ibritumomab Tiuxetan in Treating Patients With Stage I or Stage II Non-Hodgkin's Lymphoma
Lymphoma
About this trial
This is an interventional treatment trial for Lymphoma focused on measuring stage I mantle cell lymphoma, stage I adult diffuse large cell lymphoma, stage I adult Burkitt lymphoma, anaplastic large cell lymphoma, contiguous stage II adult diffuse large cell lymphoma, contiguous stage II adult Burkitt lymphoma, contiguous stage II mantle cell lymphoma, noncontiguous stage II adult diffuse large cell lymphoma, noncontiguous stage II adult Burkitt lymphoma, noncontiguous stage II mantle cell lymphoma
Eligibility Criteria
DISEASE CHARACTERISTICS: Histologically confirmed aggressive non-Hodgkin's lymphoma of 1 of the following subtypes: Diffuse large B-cell Mantle cell High-grade B-cell, Burkitt's, or Burkitt-like Anaplastic large cell (B-cell phenotype only) Stage I, IE, or non-bulky* stage II or IIE disease by Ann Arbor classification Patients who have bulky stage II or IIE disease are ineligible even if, after resection, the measurements are less than 10.0 cm NOTE: *Non-bulky disease defined as any tumor measuring less than 10.0 cm or occupying less than 1/3 of the chest diameter CD20-expressing disease by flow cytometry or immunoperoxidase staining Aggressive lymphomas must have at least 1 of the following adverse prognostic factors: Non-bulky stage II or IIE disease At least 60 years of age Zubrod performance status of 2 Lactic dehydrogenase greater than upper limit of normal All disease must be encompassable in a single radiation port (including any site of resected disease) NOTE: A new classification scheme for adult non-Hodgkin's lymphoma has been adopted by PDQ. The terminology of "indolent" or "aggressive" lymphoma will replace the former terminology of "low", "intermediate", or "high" grade lymphoma. However, this protocol uses the former terminology. PATIENT CHARACTERISTICS: Age Over 18 Performance status Zubrod 0-2 Life expectancy Not specified Hematopoietic Not specified Hepatic Not specified Renal Not specified Other Not pregnant or nursing Negative pregnancy test Fertile patients must use effective contraception No other malignancy within the past 5 years except adequately treated basal cell or squamous cell skin cancer or carcinoma in situ of the cervix No medical contraindication to study chemotherapy, rituximab, or ibritumomab tiuxetan No known AIDS syndrome or HIV-associated complex PRIOR CONCURRENT THERAPY: Biologic therapy No prior monoclonal antibody therapy Chemotherapy No prior chemotherapy for lymphoma Endocrine therapy Not specified Radiotherapy See Disease Characteristics No prior radiotherapy for lymphoma No concurrent intensity-modulated radiotherapy Planned involved-field radiotherapy must not encompass more than 25% of active bone marrow space Surgery See Disease Characteristics Other Concurrent participation in SWOG-8947 or SWOG-8819 allowed
Sites / Locations
- Alaska Regional Hospital Cancer Center
- Providence Cancer Center
- Providence Saint Joseph Medical Center - Burbank
- Mountain States Tumor Institute at St. Luke's Regional Medical Center
- Decatur Memorial Hospital Cancer Care Institute
- Cardinal Bernardin Cancer Center at Loyola University Medical Center
- Edward Hospital Cancer Center
- Regional Cancer Center at Memorial Medical Center
- Cancer Center of Kansas, PA - Chanute
- Cancer Center of Kansas, PA - Dodge City
- Cancer Center of Kansas, PA - El Dorado
- Cancer Center of Kansas-Independence
- Cancer Center of Kansas, PA - Kingman
- Southwest Medical Center
- Cancer Center of Kansas, PA - Newton
- Cancer Center of Kansas, PA - Parsons
- Cancer Center of Kansas, PA - Pratt
- Cancer Center of Kansas, PA - Salina
- Cotton-O'Neil Cancer Center
- Cancer Center of Kansas, PA - Wellington
- Associates in Womens Health, PA - North Review
- Cancer Center of Kansas, PA - Medical Arts Tower
- Cancer Center of Kansas, PA - Wichita
- CCOP - Wichita
- Via Christi Cancer Center at Via Christi Regional Medical Center
- Wesley Medical Center
- Cancer Center of Kansas, PA - Winfield
- Battle Creek Health System Cancer Care Center
- Mecosta County Medical Center
- Butterworth Hospital at Spectrum Health
- CCOP - Grand Rapids
- Lacks Cancer Center at Saint Mary's Health Care
- Hackley Hospital
- Providence Cancer Institute at Providence Hospital - Southfield Campus
- Munson Medical Center
- Metro Health Hospital
- James P. Wilmot Cancer Center at University of Rochester Medical Center
- McDowell Cancer Center at Akron General Medical Center
- Charles M. Barrett Cancer Center at University Hospital
- Cleveland Clinic Taussig Cancer Center
- Community Oncology Group at Cleveland Clinic Cancer Center
- Cleveland Clinic - Wooster
- CCOP - Greenville
- Minor and James Medical, PLLC
- Group Health Central Hospital
- Swedish Cancer Institute at Swedish Medical Center - First Hill Campus
- Polyclinic First Hill
- University Cancer Center at University of Washington Medical Center
Arms of the Study
Arm 1
Experimental
CHOP + RT + Zevalin
Patients first receive 3 cycles (21 days each) of CHOP, consisting of: cyclophosphamide 750 mg/m^2 on day 1, doxorubicin 50 mg/m^2 on day 1, vincristine 1.4 mg/m^2 on day 1, and prednisone 100 mg on days 1-5. Patients receive 4000-5000 cGy of radiation therapy in 25 fractions, starting 3 weeks after completion of CHOP. 3-6 weeks after completing RT, patients receive Zevalin, which consists of: rituximab 250 mg/m^2 on days 1 and 7, 8 or 9; In-111 ibritumomab tiuxetan 5 mCi within 4 hours after rituximab on day 1; and Y-90 ibritumomab tiuxetan 0.4 mCi/kg within 4 hours after rituximab on day 7, 8 or 9.