Chubachi A, Miura A B, Takatsu H, Yamaguchi A, Nishimura S, Nakayama Y, Akihama T, Miura S, Saitoh M, Watanuki T
Third Department of Internal Medicine, Akita University, School of Medicine.
Rinsho Ketsueki. 1992 Mar;33(3):303-10.
One hundred patients with diffuse non-Hodgkin's lymphoma were treated with combination chemotherapy including adriamycin. Seventy-one patients were under age 70 and 29 were 70 years or older. The clinical characteristics of the two groups were similar, except that the patients showed elevated serum BUN were in the elderly group. The complete remission rate in the elderly patients (66%) was slightly lower than that in the younger patients (75%) (p = NS). The average length of survival in the elderly patients was significantly shorter than in the younger patients (p less than 0.05) (projected 5-year survival: 28 +/- 11% vs 52 +/- 7%). The duration of remission for all patients in the elderly patients did not differ from that in the younger patients (projected 2-year survival: 40 +/- 10% vs 45 +/- 6%). Death during the induction chemotherapy from causes other than lymphoma occurred in 14% of patients over 70-year-old and in one percent of younger patients. At relapse, the response rate was significantly lower in the elderly patients than in the younger patients (CR+PR: 28% vs 78%, p = 0.03). To prevent toxic death in remission induction therapy, drug dose elderly patients should be attenuated according to their general conditions and performance status.
100例弥漫性非霍奇金淋巴瘤患者接受了包括阿霉素在内的联合化疗。71例患者年龄在70岁以下，29例患者年龄在70岁及以上。两组的临床特征相似，但老年组患者血清尿素氮升高。老年患者的完全缓解率（66%）略低于年轻患者（75%）（p值无统计学意义）。老年患者的平均生存期明显短于年轻患者（p<0.05）（预计5年生存率：28±11%对52±7%）。老年患者所有患者的缓解持续时间与年轻患者无差异（预计2年生存率：40±10%对45±6%）。70岁以上患者中14%在诱导化疗期间死于淋巴瘤以外的原因，年轻患者中这一比例为1%。复发时，老年患者的缓解率明显低于年轻患者（完全缓解+部分缓解：28%对78%，p=0.03）。为防止缓解诱导治疗中的毒性死亡，应根据老年患者的一般状况和体能状态调整药物剂量。
