CHOP方案治疗106例外周T细胞淋巴瘤的临床长期随访结果分析  

Clinical Outcomes of 106 Patients with Peripheral T-cell Lymphoma Treated by Standard CHOP Regimen

作　　者：黄慧强[1] 彭玉龙[1] 林旭滨[1] 孙晓菲[1] 林桐榆[1] 夏忠军[1] 李宇红[1] 蔡清清[1] 何友兼[1] 姜文奇[1] 管忠震[1] 

机构地区：[1]中山大学肿瘤防治中心内科,广东广州510060

出　　处：《癌症》2004年第z1期1443-1447,共5页Chinese Journal of Cancer

摘　　要：背景与目的:与西方国家比较,亚洲国家T细胞非霍奇金淋巴瘤(non-Hodgkinslymphoma,NHL)较为常见,其生物学行为与B细胞NHL不同,往往表现为化疗敏感性较差、病情迁延、容易复发、预后不良。本研究评价标准CHOP方案治疗外周T细胞淋巴瘤-非特异性(peripheralT-celllymphoma-unspecified,PTCL-U)患者的疗效和不良反应。方法:在1997年1月～2003年12月间,中山大学肿瘤防治中心共收治106例PTCL-U(REAL分型)患者,现回顾性分析其临床特征以及采用CHOP方案治疗后的近期疗效和远期生存率。结果:本组PTCL-U临床分期多为Ⅰ～Ⅱ期(占78.3%);结外侵犯多见(占84.0%),其中结外侵犯部位数>1者占34.9%;IPI评分多为0～1分(占78.3%)。106例PTCL-U均采用CHOP方案为主的治疗方法,单纯化疗59例(55.7%),化疗加局部侵犯野放疗46例(43.3%),术后辅助化疗1例(1.0%)。化疗加局部放疗总有效率81.0%,CR率58.2%;单纯化疗有效率69.5%,CR率为44.1%,中位有效维持时间16个月(1～88月)。中位随访时间19个月(1～89月),1年、3年和5年生存率分别为69.9%、42.9%、22.0%,中位生存期24个月(95%置信区间12～36月)。Ⅰ、Ⅱ、Ⅲ、Ⅳ期5年生存率分别为24.0%、22.3%、18.0%和0。本组病例中IPI、结外病变数和化疗是否达到CR与预后有关。BACKGROUND &OBJECTIVE: T-cell Non-Hodgkins lymphoma (NHL) ar e common in Asia,Its biological behavior is different from B-cell NHL. It ofte n shows lower chemo-sensitivity,high incidence of relapse and poor prognosis. This study was designed to analyse the clinical characteristics and to evaluate the effectiveness and toxicity of standard CHOP regimen in the treatment of peri pheral T-cell lymphomas-unspecified(PTCL-U) according to the Revised European-American Lymphoma(REAL) classification. METHODS: 106 patients with PTCL-U wer e treated by standard CHOP regimen with or without involved field radiotherapy f rom January 1997 to December 2003 in Cancer Center,Sun Yat-sen University,The c linical characteristics,response and long-term survival rates were analysed,re trospectively. RESULTS: Early stages (Ⅰ～Ⅱ) were present in 78.3%(83/106) of the patients. Extranodal involvement account for 84.0%(89/106) with 34.9%(37/1 06) of more than 1 involved extranodal sites.The percentage of IPI score 0～1 wa s 78.3%(83/106). All the patients were treated by standard CHOP regimen plus IF RT for bulky disease. 55.7%(59/106) patients were treated by chemotherapy alone and 43.3%(46/106) were treated by chemotherapy plus radiotherapy. The overall response rate was 81.0%(85/105) with 58.2%(65/105) complete remission (CR)rate s. The response rate of chemotherapy alone were 69.5%(41/59) and CR rates was 4 4.1%(26/59). The median duration of response was 16 months(1～88 months). The actual 1,3 and 5 year overall survival rates were 69.9%,42.9%and 22.0%,resp ectively. Median survival times were 24 (12～36) months. CONCLUSION: Long-term survival of PTCL-U treated by standard CHOP regimen were poor. Further investig ation is wanted.

关 键 词：外周T细胞淋巴瘤 CHOP方案 联合化疗 

分 类 号：R733.1[医药卫生—肿瘤] R730.53[医药卫生—临床医学]