分割RCHOP方案在老年初治弥漫性大B细胞淋巴瘤中的疗效与安全性分析
Efficacy and safety of separated R-CHOP in older patients with newly diagnosed dif-fuse large B-cell lymphoma
陈子琪 1李文琪 1孙金淼 1常宇 1柳喜洋 1张明智 1张蕾1
作者信息
- 1. 郑州大学第一附属医院肿瘤科(郑州市 450000)
- 折叠
摘要
目的:探究分割利妥昔单抗(rituximab)+环磷酰胺(cyclophosphamide,CTX)+长春新碱(vincristine,VCR)+多柔比星(doxorubicin)+泼尼松(prednisone)的(RCHOP方案)治疗 65～80岁初治弥漫性大B细胞淋巴瘤(diffuse large B-cell lymphoma,DLBCL)的疗效与安全性.方法:选取郑州大学第一附属医院 2013年 4月至 2022年 9月收治的 137例 65～80岁初治DLBCL患者,根据化疗方案的不同分为分割RCHOP组、足量RCHOP组和减量RCHOP样组 3组.所有患者均以 21天为 1个周期,治疗4～8 个周期.比较3组近期疗效、远期疗效和不良反应发生情况,分析患者无进展生存期(progressiom-free survival,PFS)及总生存期(overall survival,OS)的影响因素.结果:分割RCHOP组、足量RCHOP组和减量RCHOP样组的客观缓解率(overall respond rate,ORR)分别为 89.7%、90.3%、86.1%,差异无统计学意义,分割RCHOP组的完全缓解率(complete respond rate,CRR)为 64.1%高于减量RCHOP样组(33.3%),差异具有统计学意义(P=0.008),而与足量RCHOP组(66.1%)差别不大.生存曲线分析结果显示分割RCHOP组与足量RCHOP组的PFS和OS均无统计学差异.分割RCHOP组相比减量RCHOP样组改善了PFS(P=0.036),而两组的OS无统计学差异.多因素分析显示,国际预后指数(IPI)和分割RCHOP方案对DLBCL患者PFS均有显著性影响(均P<0.05),IPI评分对DLBCL患者OS具有显著性影响(P<0.001).分割RCHOP组白细胞减少及 3～4级白细胞减少的发生率低于足量RCHOP组,差异具有统计学意义(P=0.007、P=0.012),其余差异无统计学意义.结论:年龄在65～80岁的初治弥漫性大B细胞淋巴瘤患者中,分割RCHOP方案近期疗效、远期疗效及安全性、耐受性均良好.
Abstract
Objective:To investigate the efficacy and safety of separated R-CHOP in older patients with newly diagnosed diffuse large B-cell lymphoma(DLBCL).Methods:A total of 137 patients aged 65-80 years newly diagnosed with DLBCL between April 2013 and September 2022 at The First Affiliated Hospital of Zhengzhou University were enrolled.The patients were assigned into separated R-CHOP,full-dose R-CHOP,and reduced R-CHOP-like groups based on their different chemotherapy regimens.All individuals were treated in 21-day cycles for 4-8 cycles.The short-term and long-term efficacies and adverse reactions of the treatments were compared among the three groups,and factors influencing progression-free survival(PFS)and overall survival(OS)were analyzed.Results:The overall response rates(ORR)of patients in the separated R-CHOP,full-dose R-CHOP,and reduced R-CHOP-like groups were 89.7%,90.3%,and 86.1%,respectively,with no significant differences among them.The complete respond rate(CRR)of the separated R-CHOP group(64.1%)was significantly higher than that of the reduced R-CHOP-like group(33.3%)(P=0.008)but not significantly different from that of the full-dose R-CHOP group(66.1%).Survival curve analysis revealed no significant differences in PFS and OS between the separated and full-dose R-CHOP groups.Although the separated R-CHOP group showed improved PFS compared with the reduced R-CHOP-like group(P=0.036),there was no statistical difference in OS between these two groups.Multivariate analysis revealed that the international prognostic index(IPI)and separated R-CHOP had significant effects on PFS in patients with DLBCL(all P<0.05),whereas only IPI had a significant effect on OS(P<0.001).The incidence of leukopenia and grade 3-4 leukopenia in the separated R-CHOP group was significantly lower than that in the full-dose R-CHOP group(P=0.007,P=0.012),but there was no significant difference with the reduced R-CHOP-like group in this regard.Conclusions:In older patients with newly diagnosed DLBCL,separated R-CHOP showed good efficacy both in the short and long terms and had acceptable safety and tolerability profiles.
关键词
分割RCHOP方案/初治弥漫性大B细胞淋巴瘤/老年/疗效/安全性Key words
separated RCHOP regimens/newly diagnosed patients with diffuse large B-cell lymphoma/older patients/efficacy/safety引用本文复制引用
基金项目
国家自然科学基金(82000204)
河南省卫生健康委项目(232102311114)
出版年
2024
NETL
NSTL
万方数据