Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA.
Blood. 2011 May 19;117(20):5314-20. doi: 10.1182/blood-2010-10-314260. Epub 2011 Feb 25.
To reduce doxorubicin, bleomycin, vinblastine and dacarbazine toxicity, the Cancer and Leukemia Group B conducted a phase 2 trial of doxorubicin, vinblastine, and gemcitabine for newly diagnosed, nonbulky stages I and II Hodgkin lymphoma. Ninety-nine assessable patients received 6 cycles of doxorubicin 25 mg/m(2), vinblastine 6 mg/m(2), and gemcitabine 800 mg/m(2) (1000 mg/m(2) in first 6) on days 1 and 15 every 28 days. Computed tomography (CT) and positron emission tomography (PET) were performed before and after 2 and 6 cycles. Complete remission (CR)/CR unconfirmed was achieved in 72 of 99 patients (72.7%) and partial remission in 24 of 99 patients (24.2%). The CR rate was 81% when using PET criteria. Two patients have died of Hodgkin lymphoma progression. Median follow-up for nonprogressing patients is 3.3 years. The progression-free survival (PFS) at 3 years was 77% (95% confidence interval, 68%-84%). The relapse rate was less than 10% for patients with favorable prognostic factors. The 2-year PFS for cycle 2 PET-negative and -positive patients was 88% and 54%, respectively (P = .0009), compared with 89% and 27% for cycle 6 PET-negative and -positive patients (P = .0001). Although the CR rate and PFS were lower than anticipated, patients with favorable prognostic features had a low rate of relapse. Cycle 2 PET and cycle 6 PET were predictive of PFS.
为了降低多柔比星、博来霉素、长春碱和达卡巴嗪的毒性，癌症和白血病组 B 开展了一项 2 期临床试验，研究新诊断的非弥漫性 I 期和 II 期霍奇金淋巴瘤患者使用多柔比星、长春碱和吉西他滨的疗效。99 例可评估患者接受了 6 个周期的多柔比星 25mg/m²、长春碱 6mg/m²和吉西他滨 800mg/m²（第 1 个周期为 1000mg/m²），每 28 天 1 次，于第 1 天和第 15 天给药。在 2 个周期和 6 个周期前后进行了计算机断层扫描（CT）和正电子发射断层扫描（PET）。99 例患者中 72 例（72.7%）达到完全缓解（CR）/未确认的 CR，24 例（24.2%）达到部分缓解。使用 PET 标准时，CR 率为 81%。2 例患者死于霍奇金淋巴瘤进展。无进展患者的中位随访时间为 3.3 年。3 年时无进展生存率（PFS）为 77%（95%置信区间，68%-84%）。预后良好的患者复发率低于 10%。第 2 周期 PET 阴性和阳性患者的 2 年 PFS 分别为 88%和 54%（P =.0009），而第 6 周期 PET 阴性和阳性患者的 2 年 PFS 分别为 89%和 27%（P =.0001）。尽管 CR 率和 PFS 低于预期，但具有良好预后特征的患者复发率较低。第 2 周期 PET 和第 6 周期 PET 可预测 PFS。
