Division of Hematology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan.
Exp Hematol Oncol. 2012 Sep 24;1(1):30. doi: 10.1186/2162-3619-1-30.
The treatment strategy for gastric diffuse large cell lymphoma (DLBCL) has not been standardized in such as to the cycles of chemotherapy, dose of radiation, or necessity for the surgery. Although the results of CHOP or R-CHOP treatments have demonstrated the good prognosis, the treatments have been controversial in many cases.
We retrospectively analyzed 40 gastric DLBCL patients receiving chemotherapy with or without radiation in our institute. Those in stages II-IV were treated with six cycles of R-CHOP without radiation; for those in stage I, we administered three cycles of R-CHOP with radiation.
The three-year overall survival (OS) and progression-free survival (PFS) rates were 95.2 and 91.8%, respectively. Those in stage I obtained 100% of OS. The radiation dose prescribed was 30.6 Gy for CR cases and 39.6 to 40 Gy for PR after chemotherapy. Although survival rates tended to correlate with staging groups or age-adjusted IPI classifications, multivariate statistical analysis did not show clear differences. All 14 patients with initial bleeding were successfully managed without surgery during treatment.
R-CHOP therapy was very effective for gastric DLBCL. It may be not necessary to use more than 30.6 Gy of radiotherapy in the highly chemo-sensitive cases. Less toxic treatments should be made available to gastric DLBCL patients.
胃弥漫性大 B 细胞淋巴瘤（DLBCL）的治疗策略尚未标准化，例如化疗周期、放疗剂量或手术必要性。尽管 CHOP 或 R-CHOP 治疗的结果显示预后良好，但在许多情况下治疗仍存在争议。
我们回顾性分析了在我院接受化疗加或不加放疗的 40 例胃 DLBCL 患者。II-IV 期患者接受 6 周期 R-CHOP 治疗，无放疗；I 期患者接受 3 周期 R-CHOP 加放疗。
3 年总生存率（OS）和无进展生存率（PFS）分别为 95.2%和 91.8%。I 期患者 OS 为 100%。CR 患者的放疗剂量为 30.6Gy，化疗后 PR 患者为 39.6-40Gy。尽管生存率与分期组或年龄调整后的 IPI 分类相关，但多变量统计分析未显示出明显差异。所有 14 例初始出血患者在治疗过程中均无需手术成功治疗。
R-CHOP 治疗对胃 DLBCL 非常有效。在高度化疗敏感的情况下，可能不需要使用超过 30.6Gy 的放疗。应向胃 DLBCL 患者提供毒性更小的治疗方法。
