BACKGROUND: Neither chemotherapy with a single-alkylating agent nor aggressive combination chemotherapy cures advanced stage low-grade @entity1893 , even when combined with radiotherapy. Our aim was to compare administration of immediate @entity5805 treatment with a policy of delaying @entity5805 until clinical progression necessitated its use, in asymptomatic @entity1 with advanced-stage, low-grade @entity1893 . METHODS: 309 @entity1 with asymptomatic, advanced-stage, low-grade @entity1893 were recruited from 44 UK centres between @entity40511 , 1981, and July 31, 1990. 158 @entity1 were randomised to receive immediate systemic therapy with oral @entity5805 10 mg per day continuously. The remaining 151 were randomised to an initial policy of observation, with systemic therapy delayed until disease progression. In both groups, local radiotherapy to symptomatic nodes was allowed. FINDINGS: Median length of follow-up was 16 years. Overall survival or cause-specific survival did not differ between the two groups (median overall survival for oral @entity5805 5.9 [range 0-17.8] years and for observation 6.7 [0.5-18.9] years, p=0.84; median cause-specific survival 9 [0-17.8] years and 9.1 [0.67-18.9] years, respectively p=0.44). In a multivariate analysis, age younger than 60 years, erythrocyte sedimentation rate (ESR) 20 mm/h or less, and @entity5 , conferred significant advantages in both overall survival (p<0.0001, 0.03, and 0.03, respectively) and cause-specific survival (p=0.002, 0.008, and 0.001, respectively). In the observation group, at 10 years' follow-up, 19 @entity1 were alive and had not received chemotherapy. The actuarial chance of not needing chemotherapy (non-lymphoma @entity204 censored) at 10 years was 19% (40% if older than 70 years). INTERPRETATION: An initial policy of watchful waiting in @entity1 with asymptomatic, advanced stage low-grade @entity1893 is appropriate, especially in @entity1 older than age 70 years.

Long-term effect of a watch and wait policy versus immediate systemic treatment for asymptomatic advanced-stage XXXX : a randomised controlled trial.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity40511 :: ('2233', 'Gene') :: ['Feb 1'] @entity5 :: ('MESH:D009369', 'Disease') :: ['stage III disease'] @entity5805 :: ('MESH:D002699', 'Chemical') :: ['chlorambucil'] @entity1893 :: ('MESH:D008228', 'Disease') :: ['non-Hodgkin lymphoma', 'non-Hodgkin lymphomas'] @entity204 :: ('MESH:D003643', 'Disease') :: ['deaths']
@entity1893 :: (MESH:D008228,Disease) :: ['non-Hodgkin lymphoma']
