R-CHOP方案治疗Ⅲ～Ⅳ期老年DLBCL的临床疗效及耐受性分析  

R-CHOP regimen for elderly patients with Ⅲ～Ⅳ stage DLBCL

作　　者：施展[1] 沈倩雯[2] 王静文[1] 唐曦[1] 

机构地区：[1]复旦大学附属华东医院肿瘤内科,上海200040 [2]复旦大学附属华东医院放疗科,上海200040

出　　处：《实用肿瘤杂志》2014年第4期330-335,共6页Journal of Practical Oncology

摘　　要：目的探讨R-CHOP方案(利妥昔单抗、环磷酰胺、表柔比星、长春新碱、泼尼松龙)在Ⅲ～Ⅳ期≥60岁老年弥漫大B细胞淋巴瘤中的疗效及安全性。方法收集≥60岁的Ⅲ～Ⅳ期弥漫大B细胞淋巴瘤患者33例,行R-CHOP 3周方案化疗6疗程,观察治疗反应率、生存率以及相关不良反应。结果全组33例患者中,25例(75.8%)完成6疗程化疗,完全缓解(complete remission,CR)及不确定完全缓解(unconfirmed complete remission,uCR)12例(36.4%)。总有效率(完全缓解或部分缓解)为81.8%(27/33)。全组中位随访时间为25.2月(2.0-77.6月),2年总生存率为51.2%,2年无进展生存率为39.4%,2年无事件生存率为38.6%。截至随访结束,15例生存,12例(36.4%)为无瘤生存。治疗过程中2例(6.1%)因治疗相关感染死亡,>1/3的患者曾出现Ⅲ～Ⅳ级的骨髓抑制。单因素及多因素分析发现,近期疗效为CR的患者预后明显好于其他患者。结论足量的R-CHOP化疗在≥60岁老年Ⅲ～Ⅳ期弥漫大B细胞淋巴瘤患者中有较好的耐受性、安全性和有效率。但疗效持续时间短,其长期疗效仍不理想。Objective To investigate the efficacy and safety of R-CHOP regimen（ rituximab, cyclophosphamide, epirubicin, vincristine, prednisolone） for elderly patients with stage Ⅲ ～ Ⅳ diffuse large B-cell lymphoma（ DLBCL）.Methods Thirty-three patients aged ≥60 y diagnosed as stage Ⅲ ～ Ⅳ DLBCL were recruited consecutively. Six cycles of R-CHOP chemotherapy were planned. The response to treatment,treatment-related toxicity and survival of patients were analyzed. Results Twenty five out of 33 patients（ 75. 8%） completed the full cycles of chemotherapy,and 12 cases（ 36.4%） obtained complete remission（ CR） or unconfirmed complete remission（ uCR）. The overall response rate was81. 8%（ 27 /33）. Patients were followed up for a medium of 25. 2 months（ 2. 0- 77. 6 months）. Two-y overall survival（ OS）,2-y progression-free survival（ PFS） and 2-y event-free survival（ EFS） were 51.2%,39.4% and 38.6%,respectively. Fifteen patients survived. Twelve patients（ 36. 4%） survived with CR up to last follow-up and 2 patents（ 6.1%） died from treatment-related infection. Ⅲ ～ Ⅳ myelosuppression was found in over one-third of the patients.Univariate and multivariate analysis showed that superior survival was observed in patients who obtained complete remission in first-line chemotherapy. Conclusion High response rate and safety can be obtained for elderly Ⅲ ～ Ⅳ stage DLBCL patients with full dose R-CHOP regimen.

关 键 词：淋巴瘤 大B细胞 弥漫性 药物疗法 长春新碱 投药和剂量 多柔比星 投药和剂量 抗体 单克隆 治疗应用 抗肿瘤联合化疗方案 治疗应用 治疗结果 存活率 老年人 

分 类 号：R733.1[医药卫生—肿瘤]