Department of Endocrinology and Clinical Oncology, University Federico II, 80131, Naples, Italy.
World J Gastroenterol. 2010 May 28;16(20):2526-30. doi: 10.3748/wjg.v16.i20.2526.
To evaluate retrospectively the efficacy of rituximab plus chemotherapy in gastric diffuse large B cell lymphoma (DLBCL).
Sixty patients (median age: 58 years) with histologically confirmed gastric DLBCL treated at four Italian institutions between 2000 and 2007, were included in this analysis. Patients were selected by stage (I-IV, Lugano staging system), European Cooperative Oncology Group performance status (0-2) and treatment strategies. Treatment strategies were chemotherapy alone (group A, n = 30) [scheduled as cyclophosphamide, doxorubicin, vincristine and prednisone (CHOP) and CHOP-like], and chemotherapy combined with rituximab (group B, n = 30). The primary end point of the study was complete response (CR) rate; the secondary end points were disease-free survival (DFS) at 5 years and overall survival (OS).
Median follow-up was 62 mo (range: 31-102 mo). We observed a significant difference between the two groups (A vs B) in terms of CR [76.6% (23/30) vs 100%, P = 0.04) and DFS at 5 years [73.3% (22/30) vs 100%, P = 0.03). To date, 19 group A (63.3%) patients are alive and 11 have died, while all group B patients are alive. No significant differences in toxicity were observed between the two groups.
Rituximab in combination with chemotherapy improves CR rate, DFS and OS. Further prospective trials are needed to confirm our results.
回顾性评估利妥昔单抗联合化疗治疗胃弥漫性大 B 细胞淋巴瘤（DLBCL）的疗效。
本研究纳入了 2000 年至 2007 年期间在意大利的四家机构接受治疗的 60 例经组织学证实的胃 DLBCL 患者（中位年龄：58 岁）。患者是根据分期（Lugano 分期系统的 I-IV 期）、欧洲癌症研究和治疗组织体力状态（0-2 级）和治疗策略进行选择的。治疗策略包括单纯化疗（A 组，n=30）[方案为环磷酰胺、多柔比星、长春新碱和泼尼松（CHOP）和 CHOP 样]和化疗联合利妥昔单抗（B 组，n=30）。本研究的主要终点为完全缓解（CR）率；次要终点为 5 年无病生存（DFS）率和总生存（OS）率。
中位随访时间为 62 个月（范围：31-102 个月）。我们观察到两组之间（A 组与 B 组）在 CR[76.6%（23/30）与 100%，P=0.04]和 5 年 DFS[73.3%（22/30）与 100%，P=0.03]方面存在显著差异。迄今为止，A 组有 19 例（63.3%）患者存活，11 例死亡，而 B 组所有患者均存活。两组间毒性无显著差异。
利妥昔单抗联合化疗可提高 CR 率、DFS 和 OS。需要进一步的前瞻性试验来证实我们的结果。
