Skip to main content

Advertisement

SpringerLink
Log in

Primäre und sekundäre Lymphome des Gastrointestinaltraktes: Chemotherapie im primären, adjuvanten und palliativen Einsatz

Primary and secondary lymphomas of the gastrointestinal tract: Cytotoxic Chemotherapy for primary, adjuvant and palliative treatment

  • Themenschwerpunkt: Therapiekonzepte Bei Hodgkin- Und Non-Hodgkin-Lymphomen Des Gastrointestinaltraktes
  • Published:
Acta chirurgica Austriaca Aims and scope Submit manuscript

Zusammenfassung

Grundlagen: Primäre gastrointestinale Non-Hodgkin-Lymphome (NHL) treten in fallender Häufigkeit im Magen, Dünndarm, Kolorektum, Waldeyerschen Rachenring und Ösophagus auf. Die geringe Gesamtinzidenz und die Tatsache, daß bisher meist die Behandlung außerhalb klinischer Studien erfolgte, machen die Bewertung einzelner Therapiemodalitäten und ihrer Kombinationen für Remissionsinduktion, relapsfreies und Gesamtüberleben schwierig. Diese Problematik wird durch die meist gemeinsame Behandlung niedrig- und hochmaligner Entitäten in den zudem kleinen und retrospektiven Berichten verstärkt.

Methodik: Dies ist eine kritische Übersicht über den Stellenwert chemotherapeutischer Verfahren als alleiniger oder neoadjuvanter Therapie von gastrointestinalen NHL, allenfalls in Kombination mit tumorverkleinernder Operation oder Strahlentherapie. Zudem werden die Bedeutung der Chemotherapie im adjuvanten und palliativen Einsatz sowie die Rolle verschiedener Chemotherapeutikaregime und die Modifikationen der Behandlung in verschiedenen klinischen Situationen und bei differenten Tumorlokalisationen beschrieben, wie sie aus dem Stand der Literatur ableitbar sind.

Ergebnisse: In vielen Lokalisationen wird bei Stadien I mit Restriktion des Tumorbefalls auf Mukosa und Submukosa mittels Operation allein bereits eine hohe CR- und Kurationsrate erreicht, die in vielen Stadien durch adjuvante Radio- oder Chemotherapie erhöht werden kann. Die adjuvante Therapie ist aber jedenfalls bei transmuraler Tumorausbreitung in die Serosa oder Lymphknoten bzw. R1-Resektion und hochmaligner (Teil-)Komponente indiziert. Sie wird in Stadien II aufgrund der deutlich geringeren kompletten Resektabilität meist eo ipso postoperativ erforderlich. In einigen Studien konnte mittels alleiniger Chemo- ± Radiotherapie eine hohe Organpräservations-, CR- oder Heilungsrate erzielt werden, wobei der Stellenwert einer zusätzlichen primären „Debulking“-Operation ungeklärt blieb. Zumindest bei Tumoren im Waldeyerschen Rachenring waren die besten Erfolge mit Radiotherapie und anschließender CHOP-Chemotherapie zu erzielen. Hochmaligne Erkrankungen erfordern bei etablierter Chemotherapieindikation den Einsatz eines anthrazyklinhaltigen Regimes, mit Ausnahme lymphoblastischer Lymphome kann keine Überlegenheit besonders aggressiver Chemotherapien angenommen werden.

Schlußfolgerungen: Die Feststellung des wahren Stellenwertes der einzelnen therapeutischen Maßnahmen für eine erfolgreiche Therapie und eine Weiterentwicklung der derzeitigen Behandlungsqualität mit dem Ziel optimierter medizinischer Kosten-/Nutzenrelation bedarf hinkünftig konsequenter Durchführung prospektiv randomisierter klinischer Studien.

Summary

Background: Primary gastrointestinal Non-Hodgkin’s lymphomas most frequently occur in the stomach, and with a lower incidence in the intestine, colorectum, Waldeyer’s ring and esophagus. The exact value of surgery, radiotherapy and chemotherapy or the combination of these treatment modalities for the achievement of remission, relapse-free and overall survival of patients with these diseases remains ill-defined at present. This is mainly due to the fact that most series are retrospective and small, patients with high and low grade malignancies were often included in these series and patients were treated on an individualized basis outside of clinical trials.

Methods: This is a critical survey concerning the role of cytotoxic chemotherapy used alone or in combination with tumor debulking surgery or radiotherapy in the neoadjuvant, adjuvant or palliative setting. Based on the currently available literature, the usefulness of various cytotoxic regimens and the adaptation of treatment modalities to individual clinical situations and to the localization of the neoplasma are discussed.

Results: In many organ sites surgical resection of localized stage disease restricted to the mucosa and submucosa alone may be sufficient for a long-term disease free survival, and the relapse rate may be reduced and the cure rate increased by adjuvant radio- and/or chemotherapy. Both treatment modalities are mostly considered necessary in situations of tumor spread through the serosa, lymph node involvement, R1-resection or a high grade malignant component of the resected tissue. In most cases, adjuvant therapy is necessary in stage II disease, since the tumor may not be resected completely and the likelihood of dissemination may be increased. In some series on localized stages of disease, a high rate of organ conservation, CR rate and overall survival could be achieved by chemo ± radiotherapy alone, while the role of primary surgical debulkment in conjunction with combined treatment modality remains widely undefined. At least in tumors of the Waldeyer ring, radiotherapy and adjuvant chemotherapy with CHOP proved superior to any other treatment modality. High-grade NHL definitely require anthracyclin-containing regimes, but with the exception of lymphoblastic NHL the role of more aggressive treatment regimes remains open.

Conclusions: The contribution of individual modalities to the successful treatment of gastrointestinal lymphomas as well as an improvement in the therapeutical cost/benefit ratio urgently call for the future performance of large controlled prospective clinical trials.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Literatur

  1. Aozasa K, Ueda T, Kurata A, et al: Prognostic value of histological and clinical factors in 56 patients with gastrointestinal lymphoma. Cancer 1988;61:309.

    Article  CAS  PubMed  Google Scholar 

  2. Auger MJ, Allan NC: Primary ileocecal lymphoma: a study of 22 patients. Cancer 1990;65:358–361.

    Article  CAS  PubMed  Google Scholar 

  3. Aviles A, Delgado S, Ruiz H, de-la-Torre A, Guzman R, Talavera A: Treatment of non-Hodgkin’s lymphoma of Waldeyer’s ring: radiotherapy versus chemotherapy versus combined therapy. Eur J Cancer B Oral Oncol 1996;32B:19–23.

    Article  CAS  PubMed  Google Scholar 

  4. Blazquez M, Haioun C, Chaumette MT, et al: Low grade B cell mucosa-associated lymphoid tissue lymphoma of the stomach: clinical and endoscopic features, treatment, and outcome. Gut 1992;33:1621–1625.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Brooks JJ, Enterline HT: Primary gastric lymphomas: a clinicopathologic study of 58 cases with long-term follow-up and literature review. Cancer 1983;51:701–711.

    Article  CAS  PubMed  Google Scholar 

  6. Chen, MG, Prosnitz LR, Gonzalez-Serva A, Fischer DB: Results of radiotherapy in control of stage I and II non-Hodgkin’s lymphoma. Cancer 1979;43:1245–1254.

    Article  CAS  PubMed  Google Scholar 

  7. Cogliatti SB, Schmid U, Schumacher U, et al: Primary B-cell gastric lymphoma: a clinicopathological study of 145 patients. Gastroenterology 1991;101:1159–1170.

    Article  CAS  PubMed  Google Scholar 

  8. Cohen AM, Minsky BD, Schilsky RL: Cancer of the colon. Section 7, in DeVita VT Jr, Hellman S, Rosenberg SA (eds): Cance. Principles and practice of oncology. Philadelphia, Lippincott-Raven, 1997, pp 1144–1197.

    Google Scholar 

  9. Coiffier B: Which treatment for mantle cell lymphoma patients in 1998? Editorial. J Clin Oncol 1998;16:3–5.

    CAS  PubMed  Google Scholar 

  10. Colby TV, Hoppe RT, Warnke RA: Hodgkin’s disease at autopsy: 1972–1977. Cancer 1981;47:1852–1862.

    Article  CAS  PubMed  Google Scholar 

  11. Contreary K, Nance FC, Becker WF: Primary lymphoma of the gastrointestinal tract. Ann Surg 1980;191:593–598.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Dawson I, Cornes J, Morson B: Primary malignant lymphoid tumors of the gastrointestinal tract: report of 37 cases with a study of factors influencing prognosis. Br J Surg 1961;49:80–89.

    Article  CAS  PubMed  Google Scholar 

  13. delValle F, Hiddemann W, Willich N, et al: Clinical presentation of 371 primary gastrointestinal lymphomas: results of a prospective multicenter study (#1507). Blood 1997;336 (abstr).

  14. Devaney K, Jaffe E: The surgical pathology of gastrointestinal Hodgkin’s disease. Am J Clin Pathol 1991;95:794–801.

    Article  CAS  PubMed  Google Scholar 

  15. Devine RM, Beart RW, Wolff BG: Malignant lymphoma of the rectum. Dis Colon Rectum 1986;29:821.

    Article  CAS  PubMed  Google Scholar 

  16. Dragosicz B, Bauer P, Radaskiewicz T: Primary gastrointestinal non-Hodgkin lymphoma. Cancer 1985;55:1060–1073.

    Article  Google Scholar 

  17. d’Amore F, Brincker H, Gronbaek K, et al: Non-Hodgkin’s lymphoma of the gastrointestinal tract: a population-based analysis of incidence, geographic distribution, clinicopathologic presentation features and prognosis. J Clin Oncol 1994;12:1673–1684.

    PubMed  Google Scholar 

  18. Fischbach W, Böhm S, Wilms K: Eine akutelle Übersicht zu Inzidenz, histopathologischer Klassifikation, Stadieneinteilung, Prognose, Diagnostik und Therapie. Dtsch Ärzteblatt 1993;24:1797–1804.

    Google Scholar 

  19. Fischbach W, Kestel W, Kirchner T, et al: Malignant lymphomas of the upper gastrointestinal tract. Results of a prospective study in 103 patients. Cancer 1992;70:1075–1080.

    Article  CAS  PubMed  Google Scholar 

  20. Fleming ID, Michell S, Dilawari RA: The role of surgery in the management of gastric lymphoma. Cancer 1982;49:1135–1141.

    Article  CAS  PubMed  Google Scholar 

  21. Freeman C, Berg JW, Cutler SJ: Occurrence and prognosis of extranodal lymphomas. Cancer 1972;29:252–260.

    Article  CAS  PubMed  Google Scholar 

  22. Gobbi PG, Dionigi P, Barbieri F, et al: The role of surgery in the multimodal treatment of primary gastric Non-Hodgkin’s lymphomas. Cancer 1990;65:2528–2536.

    Article  CAS  PubMed  Google Scholar 

  23. Gospodarowicz MK, Bush RS, Brown TC, Tchua T: Curability of gastrointestinal lymphoma with combined surgery and radiation. Int J Radiat Oncol Biol Phys 1983;9:3.

    Article  CAS  PubMed  Google Scholar 

  24. Greil R: Prognosis and managements strategies of lymphatic neoplasias in the elderly: Part I: aggressive non-Hodgkin’s lymphomas. Oncology 1998;55:189–217.

    Article  CAS  PubMed  Google Scholar 

  25. Grogan TM, Berard CV, Steinhorn SC, et al: Changing patterns of Hodgkin’s disease at autopsy: a 25-year experience at the National Cancer Institute, 1953–1978. Cancer Treat Rep 1982;66:653–665.

    CAS  PubMed  Google Scholar 

  26. Haber DA, Mayer RJ: Primary gastrointestinal lymphoma. Semin Oncol 1988;15:154–169.

    CAS  PubMed  Google Scholar 

  27. Haim N, Levivov M, Ben-Arieh Y, et al: Intermediate-and high-grade gastric non-Hodgkin’s lymphoma: a prospective study of non-surgic al treatment with primary chemotherapy with or without radiotherapy. Leukemia and Lymphoma 1995;17:321–326.

    Article  CAS  PubMed  Google Scholar 

  28. Hammel P, Heioun C, Chaumette MT, et al: Efficacy of single-agent chemotherapy in low-grade B-cell mucosa-associated lymphoid tissue lymphoma with prominent gastric expression. J Clin Oncol 1995;13:2524–2429.

    CAS  PubMed  Google Scholar 

  29. Hande KR, Fisher RI, DeVita VT, et al: Diffuse histiocytic lymphoma involving the gastrointestinal tract. Cancer 1978;41:1984–1989.

    Article  CAS  PubMed  Google Scholar 

  30. Harris NL: Extranodal lymphoid infiltrates and mucosa-associated lymphoid involving the gastrointestinal tract. Cancer 1978;41:1984–1989.

    Article  Google Scholar 

  31. Harris NL, Jaffe ES, Stein H, et al: A revised European-American classification of lymphoid neoplasms: a proposal from the International Lymphoma Study Group. Blood 1994;84:1361–1392.

    CAS  PubMed  Google Scholar 

  32. Herrman R, Panahon AM, Barcos MP, Walsh D, Stutzman L: Gastrointestinal involvement in non-Hodgkin’s lymphoma. Cancer 1980;46:215–222.

    Article  Google Scholar 

  33. Hwang WS, Yao JCT, Cheng SS, Tseng HH: Primary colorectal lymphoma in Taiwan. Cancer 1992;70:575–580.

    Article  CAS  PubMed  Google Scholar 

  34. Isaacson P, Spencer J, Finn T: Primary B-cell gastric lymphoma. Human Pathol 1986;17:72–82.

    Article  CAS  Google Scholar 

  35. Isaacson P, Wright DH: Malignant lymphoma of mucosa-associated lymphoid tissue. Cancer 1983;52:1410–1416.

    Article  CAS  PubMed  Google Scholar 

  36. Isaacson PG, Nortan AJ: Extranodal lymphomas. Churchill Livingstone, 1994, pp 15–65.

  37. Isaacson PG, Spencer J: Malignant lymphoma of mucosa-associated lymphoid tissue. Histopathology 1987;11:445–462.

    Article  CAS  PubMed  Google Scholar 

  38. Isaacson PC, Spencer J, Wright DH: Classifying primary gut lymphomas. Lancet 1988;II:1148–1149.

    Article  Google Scholar 

  39. Jinnai D, Awasa Z, Watanuke T: Malignant lymphoma of the large intestine: operative results in Japan. Jpn J Surg 1983;13:331–333.

    Article  CAS  PubMed  Google Scholar 

  40. Jones SE, Fuks Z, Kaplan HS, Rosenberg SA: Non-Hodgkin’s lymphomas. V. Results of radiotheapy. Cancer 1973;32:682–691.

    Article  CAS  PubMed  Google Scholar 

  41. Kashimura A, Murakami T: Malignant lymphoma of large intestine: 15 year experience and review of literature. Gastroenterol Jpn 1976;11:141–147.

    CAS  PubMed  Google Scholar 

  42. Kath R, Donhuijsen K, Hayungs J, Albrecht K, Seeber S, Höffken K: Primary gastric non-Hodgkin’s lymphoma: a clinocpathological study of 41 cases. J Cancer Res Clin Oncol 1995;121:51–56.

    Article  CAS  PubMed  Google Scholar 

  43. Konsensus der CAO, AIO und ARO zur Diagnostik und Therapie des primären Magenlymphoms. Zbl Chir 1996;121:599–602.

    Google Scholar 

  44. Kuse R, Sonnen R: Long-term outcome after conservative treatment of patients with localized gastric non-Hodgkin’s lymphomas (#346). Blood 1997;80a (abstr).

  45. Lennert K, Mohri N, Stein H, Kaiserling E: The histopathology of malignant lymphoma. Br J Haematol 1975;31(Suppl): 193.

    Article  Google Scholar 

  46. Li G, Hansmann L, Zwingers T, Lennert K: Primary lymphomas of the lung: morphological, immunohistochemical and clinical features. Histopathology 1990;16:519–531.

    Article  CAS  PubMed  Google Scholar 

  47. Liang R, Chiu E, Todd D, Chan K, Choy D, Loke SL: Chemotherapy for early stage gastrointestinal lymphoma. Cancer Chemother Pharmacol 1991;27:385–388.

    Article  CAS  PubMed  Google Scholar 

  48. Liang R, Todd D, Chan TK, et al: Prognostic factors for primary gastrointestinal lymphoma. Hematol Oncol 1995;13:153–163.

    Article  CAS  PubMed  Google Scholar 

  49. List AF, Greer JP, Cansar JC, et al: Non-Hodgkin’s lymphoma of the gastro-intestinal tract: an analysis of clinical and pathological features affecting outcome. J Clin Oncol 1988;6:1125–1133.

    CAS  PubMed  Google Scholar 

  50. Lybeert MLM, DeNeve W, Vrints LW, Coen V, Coebergh JWW: Primary gastric Non-Hodgkin’s lymphoma stage IE and IIE. Eur J Cancer 1996;32A:2306–2311.

    Article  CAS  PubMed  Google Scholar 

  51. Maor MH, Maddux B, Osborne M: Stages IE and IIE non-Hodgkin’s lymphomas of the stomach. Comparison of treatment modalities. Cancer 1984;54:2330–2337.

    Article  CAS  PubMed  Google Scholar 

  52. Maor MH, Velasquez WS, Fuller LM, Silvermintz KB: Stomach conservation in stages IE and IIE gastric non-Hodgkin’s lymphoma. J Clin Oncol 1990;8:266–271.

    CAS  PubMed  Google Scholar 

  53. Miller TP, Dahlberg S, Cassady JR, et al: Three cycles of CHOP (3) plus radiotherapy (RT) is superior to eight cycles of CHOP (8) alone for localized intermediate and high-grade non-Hodgkin’s lymphoma (NHL): A Southwest Oncology Group Study (#1275). Proc Am Soc Clin Oncol 1996;12:411 (abstr).

    Google Scholar 

  54. Mittal B, Wasserman TH, Griffith RC: Non-Hodgkin’s lymphoma of the stomach. Am J Gastroenterol 1983;78:780–787.

    CAS  PubMed  Google Scholar 

  55. Musshof K: Klinische Stadieneinteilung der Nicht-Hodgkin-Lymphome. Strahlentherapie 1977;153:218–221.

    Google Scholar 

  56. Musshof K, Schmitt-Vollmer H: Prognosis of non-Hodgkin’s lymphomas with special emphasis on the staging classification. Z Krebsforsch 1975;83:323.

    Article  Google Scholar 

  57. Naqvi MS, Burrows L, Kark AE: Lymphoma of the gastrointestinal tract: prognostic guides based on 162 cases. Ann Surg 1969;170:221.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  58. Ossenkoppele GJ, Mol JJ, Snow GB, et al: Radiotherapy verus radiotherapy plus chemotherapy in stages I and II non-Hodgkin’s lymphoma of the upper digestive and respiratory tract. Cancer 1987;60:1505–1509.

    Article  CAS  PubMed  Google Scholar 

  59. Otter R, Bieger R, Kluin PM, Hermans J, Williemze R: Primary gastrointestinal non-Hodgkin’s lymphoma in a population-based registry. Br J Cancer 1989;60:745–750.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  60. Pasini F, Ambrosetti A, Sabbioni R, et al: Postoperative chemotherapy increases the disease-free survival rate in primary gastric lymphomas stage IE and IIE. Eur J Cancer 1994;30A:33–36.

    Article  CAS  PubMed  Google Scholar 

  61. Paulson S, Shehan RG, Stone MS: Large cell lymphomas of the stomach: improved prognosis with complete resection of all intrinsic gastrointestinal disease. J Clin Oncol 1983;1:263–269.

    CAS  PubMed  Google Scholar 

  62. Paulson S, Shehan RG, Stone MJ, Frenkel EP: Large cell lymphomas of the stomach: improved prognosis with complete resection of all intrinsic gastrointestinal disease. J Clin Oncol 1983;1:263–269.

    CAS  PubMed  Google Scholar 

  63. Perry PM, Cross RM, Morson BC: Primary malignant lymphoma of the rectum (22 cases). Proc Soc Med 1972;65:8.

    Google Scholar 

  64. Richards MA: Lymphoma of the colon and rectum. Postgrad Med J 1986;62:615.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  65. Rigacci L, Bellesi G, Alterini R, Bernardi F, DiLollo S, Ferrini PR: Combined surgery and chemotherapy in primary gastric non-Hodgkin’s lymphoma: a retrospective study in sixty-six patients. Leukemia and Lymphoma 1994;14:483–489.

    Article  CAS  PubMed  Google Scholar 

  66. Rohatiner A, on behalf of d’Amore F., Coiffier B, et al: Report on workshop convened to discuss the pathiological and staging classifications of gastrointestinal tract lymphoma. Ann Oncol 1994;5:397–400.

    Article  CAS  PubMed  Google Scholar 

  67. Rosen CB, van-Heerden JA, Kirkmartin J, Wold E, Ilstrup DM: Is an aggressive surgical approach to the patient with gastric lymphoma warranted? Ann Surg 1987;205:634–640.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  68. Rosenberg SA, Berard CW, Brown BE, et al: National Cancer Institute sponsored study of classifications of Non-Hodgkin’s lymphomas. Summary and description of a working formulation for clinical usage. Cancer 1982;49:2112–2135.

    Article  Google Scholar 

  69. Rosenfelt F, Rosenberry SA: Difusse histiocytic lymphoma presenting with gastrointestinal tract lesions: the Stanford experience. Cancer 1980;45:2188.

    Article  CAS  PubMed  Google Scholar 

  70. Ruskone-Fourmestraux A, Aegerter P, Delmer A, et al: Primary digestive tract lymphoma: a prospective multicentric study of 91 patients. Gastroenterology 1993;105:1662–1671.

    Article  CAS  PubMed  Google Scholar 

  71. Salle G, Herbrecht R, Tilly H, et al: Aggressive primary gastrointestinal lymphomas: review of 91 patients treated with the LNH-84 regimen. A study of the Groupe d’Étude des Lymphomes aggressifs. Am J Med 1991;90:77–84.

    Article  Google Scholar 

  72. Sandler RS: Primary gastric lymphoma: a review. Am J Gastroenterol 1984;79:c21-c25.

    Google Scholar 

  73. Seifert E, Schulte F, Stolte M: Long-term results of treatment of malignant non-Hodgkin’s lymphoma of the stomach. Z Gastroenterol 1992;30:505–508.

    CAS  PubMed  Google Scholar 

  74. Seitz JF, Giovanni M, Monges G, et al: Interet de la fibroscopie digestive haute dans le bilan d’éxtension des lymphomes malins non Hodgkiniens extra-digestifs. Gastroenterol Clin Biol 1990;14:961–965.

    CAS  PubMed  Google Scholar 

  75. Severson RK, Davis S: Increasing incidence of primary gastric lymphoma. Cancer 1990;66:1283–1287.

    Article  CAS  PubMed  Google Scholar 

  76. Shepherd FA, Evans WK, Kutas G, et al: Chemotherapy following surgery for stages IE and IIE non-Hodgkin’s lymphoma of the gastrointestinal tract. J Clin Oncol 1988;6:253–260.

    CAS  PubMed  Google Scholar 

  77. Shepherd NA, Hall PA, Coates PJ, Levison DA: Primary malignant lymphoma of the colon and rectum: a histopathological and immunohistochemical analysis of 45 cases with clinicopathological correlations. Histopathology 1988;12:235.

    Article  CAS  PubMed  Google Scholar 

  78. Sheridan WP, Medley G, Brodie GN: Non-Hodgkin’s lymphoma of the stomach: a prospective pilot study of surgery plus chemotherapy in early and advanced disease. J Clin Oncol 1985;3:495–500.

    CAS  PubMed  Google Scholar 

  79. Shi XH: Treatment of primary gastric non-Hodgkin’s lymphoma. Chung Hua Chung Liu Tsa Chin 1991;13:132–134.

    CAS  Google Scholar 

  80. Shimm DS, Dosoretz DE, Anderson T, et al: Primary gastric lymphoma: an analysis with emphasis on prognostic factors and radiation therapy. Cancer 1983;52:2044–2048.

    Article  CAS  PubMed  Google Scholar 

  81. Shimodeira M, Tsukamoto Y, Niwa Y, et al: A proposed staging system for primary gastric lymphoma. Cancer 1994;73:2709–2715.

    Article  Google Scholar 

  82. Shiu MH, Nisce LZ, Lourdes AN: Recent results of multimodal therapy of gastric lymphoma. Cancer 1986;65:301–313.

    Google Scholar 

  83. Shiu MH, Nisce LZ, Pinna A, et al: Recent results of multimodal therapy of gastric lymphoma. Cancer 1986;58:1389–1399.

    Article  CAS  PubMed  Google Scholar 

  84. Shiu MM, Karas M, Nisce B, et al: Management of primary gastric lymphoma. Ann Surgery 1982;195:196–202.

    Article  CAS  Google Scholar 

  85. Steward WP, Harris M, Wagstaff J, et al: Management of primary gastric lymphoma. Ann Surgery 1982;195:196–202.

    Article  Google Scholar 

  86. Taal BG, Burgers JM: Primary non-Hodgkin’s lymphoma of the stomach: endoscopic diagnosis and the role of surgery. Scand J Gastroenterol Suppl 1991;188:33–37.

    Article  CAS  PubMed  Google Scholar 

  87. Taal BG, Burgers JM, van-Heerde P, Hart AA, Somers R: The clinical spectrum and treatment of primary non-Hodgkin’s lymphoma of the stomach (see comments). Ann Oncol 1993;4:839–846.

    CAS  PubMed  Google Scholar 

  88. Taal BG, DenHaartog Jager FCA, Bergeres JMV: Primary Non-Hodgkin’s lymphomas of the stomach: Changing aspects and therapeutic choice. Eur J Cancer Clin Oncol 1989;25:429–450.

    Article  Google Scholar 

  89. Valentini M, Bortoluzzi F, Cannizzaro R, et al: Gastroduodenal involvement in staging of nodal Non-Hodgkin lymphomas: a clinical and endoscopic prospective study of 235 patients. Am J Gastroenterol 1995;90:1959–1961.

    CAS  PubMed  Google Scholar 

  90. Van den Heule B, Taylor CR, Terry R, Lukes RJ: Presentation of malignant lymphoma in the rectum. Cancer 1982;49:2602.

    Article  Google Scholar 

  91. Vose J, Ruby E, Blerman P, Anderson J, Wissenburger D, Armitage JO: Elderly patients with localized diffuse large cell non-Hodgkin’s lymphoma (NHL): Improved results with initial chemotherapy (#1519). Blood 1994;83:383a (abstr).

    Google Scholar 

  92. Weingrad DN, Decosse JJ, Sherlock P, et al: Primary gastrointestinal lymphoma: a 30-year review. Cancer 1982;49:1258–1265.

    Article  CAS  PubMed  Google Scholar 

  93. Wood NL, Coltman CA: Localized primary extranodal Hodgkin’s disease. Ann Intern Med 1973;78:113–118.

    Article  CAS  PubMed  Google Scholar 

  94. Wychulis AR, Beahrs OH, Woolner LB: Malignant lymphoma of the colon. Arch Surg 1966;93:215–225.

    Article  CAS  PubMed  Google Scholar 

  95. Yahalom J, Varsos G, Fuks Z, Myers J, Clarkson BD, Straus DJ: Adjuvant cyclophosphamide, doxorubicin, vincristine, and prednisone chemotherapy after radiation therapy in stage I low-grade and intermediate-grade non-Hodgkin lymphoma. Results of a prospective randomized study. Cancer 1993;71:2342–2350.

    Article  CAS  PubMed  Google Scholar 

  96. Zinzani P, Frezza G, Bendani M, et al: Primary gastric lymphoma: a clinical and therapeutic evaluation of 82 patients. Leukemia and Lymphoma 1995;19:461–466.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Abteilung für Hämatologie und Onkologie, Universitätsklinik für Innere Medizin, Anichstraße 35, A-6020, Innsbruck, Austria

    R. Greil

Authors
  1. R. Greil
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to R. Greil.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Greil, R. Primäre und sekundäre Lymphome des Gastrointestinaltraktes: Chemotherapie im primären, adjuvanten und palliativen Einsatz. Acta Chir Austriaca 30, 274–281 (1998). https://doi.org/10.1007/BF02620108

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02620108

Schlüsselwörter

Key-words

Search

Navigation