评价R-CHOP方案对初治弥漫大B细胞淋巴瘤患者的有效性、安全性及预后的影响：一项回顾性多中心长期随访研究  

Evaluation of the impact of R-CHOP chemotherapy on efficacy, safety and prognosis in newly diag- nosed diffuse large B-cell lymphoma patients and its prognostic impact： a multicenter retrospective study with long term follow-up

作　　者：程志祥[1] 邹善华[1] 李锋[1] 李军民[2] 王健民[3] 陈芳源[4] 曹军宁[5] 王椿[6] 魏征[1] 程韵枫[1] 

机构地区：[1]复旦大学附属中山医院血液科,上海200032 [2]上海交通大学附属瑞金医院血液科 [3]第二军医大学附属长海医院血液科 [4]上海交通大学附属仁济医院血液科 [5]复旦大学附属肿瘤医院肿瘤内科 [6]上海交通大学附属上海市第一人民医院血液科

出　　处：《中华血液学杂志》2012年第4期257-260,共4页Chinese Journal of Hematology

摘　　要：目的观察R—CHOP方案对初治弥漫大B细胞淋巴瘤（DLBCL）患者的有效性、安全性及长期预后的影响，并与CHOP方案作比较。方法2000年1月1日至2010年5月1日507例初发DLBCL患者进入本研究，分为CHOP及R—CHOP两组。CHOP组接受6个疗程CHOP方案，R—CHOP组患者接受至少4个疗程R—CHOP方案化疗，之后两个疗程采用R—CHOP方案或CHOP方案治疗。利妥昔单抗剂量为375mg／m2，CHOP方案：环磷酰胺750mg／m2、阿霉素50mg／m2、长春新碱1．4mg／m2（最大剂量2．0mg／m2）、泼尼松60—100mg。结果411例可分析病例中，CHOP组224例，其中完全反应（CR）160例（71．43％），总有效率（ORR）为87．95％；R—CHOP组187例，其中CR144例（77．01％），ORR为95．19％。R—CHOP组较CHOP组的ORR显著提高（P=0．007）。CHOP组中位随访时间35．2个月，R—CHOP组中位随访时间28．1个月，随访至终点时，CHOP组预期中位无进展生存（PFS）时间84．8个月，R—CHOP组尚未达到中位PFS，两组均未达到中位总生存（OS）时间。采用Kaplan—Meier法进行生存分析，两组患者的PFS及OS间差异有统计学意义（P值均〈0．05）。R-CHOP组不良反应与CHOP组类似。结论利妥昔单抗联合CHOP方案可有效用于初治DLBCL，具有更高的缓解率，延长PFS时间和提高OS率，同时未明显增加不良反应。Objective To evaluate the efficacy, safety and prognostic impact of rutiximab plus CHOP （R-CHOP） regimen on patients with diffuse large B-cell lymphoma（ DLBCL）, to access the impact of R-CHOP on patients＇ prognosis and to compare that with CHOP regimen. Methods Five hundred and seven newly diagnosed DLBCL patients were enrolled from Jan. 1, 2000 to May 1, 2010. Patients were adminis- tered with 6 cycles of CHOP or at least 4 cycles of R-CHOP treatments. Rutiximab was administered intrave- nously on day1 at a dose of 375 mg/m2. The typical CHOP regimen include cyclophosphamide （750 mg/m2, Ⅳ ） , doxorubiein （ 50 mg/m2, Ⅳ ） and vineristine （ 1.4 mg/m2, Ⅳ, maximum 2 mg ） and prednisone （60 - 100 rag, oral, day 3 - 7）. The complete response（CR） rates, overall response（OR） rates, and side events of these 2 groups were compared. Results Of the 411 analyzable patients, 224 received CHOP regimen and 187 received R-CHOP regimen. CR rate for R-CHOP group and CHOP group was 77.01% and 71.43%, respectively. OR rate in R-CHOP group was higher than that in the CHOP group （95. 19% vs 87.95% , P = 0. 007 ）. The median follow-up time of R-CHOP group was 28.1 months vs that of 35.2 months in CHOP group. There was significant difference in progression free survival （PFS） and overall survival （OS） between 2 groups（ P = 0. 018 and 0. 034, respectively）. At the end of follow-up, the estimated median PFS in R-CHOP group had not been reached, while that was 84.8 months in CHOP group. The median OS in both groups had not yet been reached. The adverse events in R-CHOP group were similar with that in CHOP group. Conclusions R-CHOP is a safe and effective regimen for management of newly diagnosed DLBCL, with a better remission rate, PFS and OS.

关 键 词：淋巴瘤 弥漫大B细胞 抗肿瘤联合化疗方案 抗体 单克隆 CD20 多中心研究 回顾性研究 

分 类 号：R733.1[医药卫生—肿瘤]