CHOPE与CHOPE-L方案治疗65例外周T细胞淋巴瘤非特异型效果及预后影响因素分析  

Treatment response and prognostic factors in 65 patients with peripheral T cell lymphoma-unspecified treated by CHOPE and CHOPE-L chemotherapy

作　　者：李佳[1] 刘卓刚[1] 

机构地区：[1]中国医科大学附属盛京医院第一血液内科,辽宁沈阳110022

出　　处：《中国医药导报》2015年第17期55-59,共5页China Medical Herald

基　　金：辽宁省科学技术计划项目(2010225032)

摘　　要：目的：评价应用CHOPE与CHOPE-L方案治疗外周T细胞淋巴瘤非特异型（PTCL-U）的效果及其预后影响因素。方法对2005年1月～2012年1月经中国医科大学附属盛京医院病理及免疫组化确诊的65例PTCL-U患者的资料进行回顾性分析，评价CHOPE与CHOPE-L方案的治疗效果及其预后影响因素。结果20例应用CHOPE方案治疗，完全缓解（CR）4例（20.0%），部分缓解（PR）5例（25.0%），总有效率（OR）为45.0%；1、2、3年的总生存率分别为75.0%、40.0%及15.0%。45例应用CHOPE-L方案治疗，CR 12例（26.7%），PR 19例（42.2%），OR为68.9%；1、2、3年的总生存率分别为82.2%、62.2%及40.0%。 Ann Arbor分期Ⅰ～Ⅱ期、结外侵犯0～1个、无骨髓侵犯、Ki-67≤50%及应用CHOPE-L方案的患者较Ann Arbor分期Ⅲ～Ⅳ期、结外侵犯≥2个、有骨髓侵犯、Ki-67〉50%及应用CHOPE方案的患者化疗有效率高，差异有统计学意义（P〉0.05）。一般状况评分（ECOG评分）0～1分、国际预后指数（IPI）评分≤2分、Ki-67≤50%及应用CHOPE-L方案化疗的患者较ECOG评分2～4分、IPI评分〉2分、Ki-67〉50%及应用CHOPE方案化疗的患者3年生存率高，差异有统计学意义（P〈0.05）。多因素分析显示，IPI评分是本组病例的独立预后因素（P〈0.05）。结论 PTCL-U是一类预后不良的疾病，左旋门冬酰胺酶（L-ASP）的应用提高了化疗有效率及3年生存率，且安全性好，不良反应可耐受。 Ann Arbor分期、结外侵犯、骨髓侵犯、Ki-67及化疗方案是影响近期疗效的重要因素。患者的ECOG评分、IPI评分、Ki-67及化疗方案是影响患者预后的重要因素。Objective To investigate the treatment response and prognostic factors in patients with peripheral T cell lymphomas-unspecified （PTCL-U） treated by CHOPE and CHOPE-L chemotherapy. Methods The clinical data of 65 pathology and immunohistochemistry confirmed patients with PTCL-U in Shengjing Hospital Affiliated to China Medi- cal University from January 2005 to January 2012 were retrospectively analyzed, in order to evaluate the treatment re- sponse and prognosic factors of CHOPE and CHOPE-L chemotherapy. Resuits Of 20 cases treated by CHOPE, com- plete remission （CR） rate was 20.0% （4/20）, partial remission （PR） rate was 25.0% （5/20） and overall response （OR） rate was 45.0%.The overall survival rates of 1, 2 and 3 years was 75.0%, 3,0.0% and 15.0% respectively. of 45 cases treated by CHOPE-L, CR rate was 26.7% （12/45）, PR rate was 42,2% （19/45） and OR rate was 68.9%. The overall survival rates of 1, 2 and 3 years was 82.2%, 62.2% and 4Q,Q% respectively. Ann Arbor stage Ⅰ-Ⅱ, extranodal in- volvement of 0-1, the patients without bone marrow involvement, Ki-67 ≤50% and the application of CHOPE-L chemotherapy had a better recent curative effect compared with Ann Arbor stage 11I- IV, extranodal involvement of more than two, the patients with bone marrow involvement, Ki-67 〉 50% and the application of CHOPE chemotherapy（P 〈 0.05）. ECOG scoring 0-1, International prognostic index （IPI） ≤2, Ki-67 ≤50% and the application of CHOPE-L chemotherapy had a higher 3-year overall survival rate compared with ECOG scoring 2-4, IPIscoring ≥2, Ki-67 〉 50% and the application of CHOPE chemotherapy （P 〈 0.05）. Multi-factors analysis of IPI scoring was independent prognostic factors in this group of patients （P 〈 0.05）. Conclusion PTCL-U is a kind of disease with poor prognosis. The use of L-asparaginase （L-ASP） improves the rate of response to chemotherapy and survival rate in 3 years. The security is good and the side effects can be tolerated. Ann Arbor stage, e

关 键 词：外周T细胞淋巴瘤 CHOPE方案 左旋门冬酰胺酶 预后因素 治疗 

分 类 号：R734[医药卫生—肿瘤]