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I/II期边缘区淋巴瘤经确定性局部治疗后进行额外化疗是否有作用?淋巴瘤生存改善联盟(CISL)研究。

Is there role of additional chemotherapy after definitive local treatment for stage I/II marginal zone lymphoma?: Consortium for Improving Survival of Lymphoma (CISL) study.

作者信息

Koh Myeong Seok, Kim Won Seog, Kim Seok Jin, Oh Sung Yong, Yoon Dok Hyun, Lee Soon Il, Hong Junshik, Song Moo Kon, Shin Ho-Jin, Kwon Jung Hye, Kim Hyo Jung, Do Yong Rok, Suh Cheolwon, Kim Hyo Jin

机构信息

Department of Internal Medicine, Dong-A University College of Medicine, Daeshin Park road 26, Seo-gu, Pusan, 602-715, Korea.

Division of Hematology/Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

出版信息

Int J Hematol. 2015 Oct;102(4):420-5. doi: 10.1007/s12185-015-1845-6. Epub 2015 Jul 26.

Abstract

Even though local stage (Ann Arbor stage I/II) marginal zone lymphoma (MZL) is well controlled with local treatment-based therapy, no data exist on the role of additional chemotherapy after local treatment for stage I/II MZL. Patients with biopsy-confirmed Ann Arbor stage I/II MZL (n = 210) were included for analysis in this study. Of these, 180 patients (85.7 %) were stage I and 30 (14.3 %) were stage II. Most patients (n = 182, 86.7 %) were treated with a local modality including radiation therapy or surgery and 28 (13.3 %) received additional systemic chemotherapy after local treatment. The overall response rate was 98.3 % (95 % CI 96-100 %), with 187 complete responses and 20 partial responses. In the local treatment group, the mean progression-free survival (PFS) was 147.4 months (95 % CI 126.7-168.1 months) and the overall survival (OS) was 188.2 months (95 % CI 178.8-197.7 months). In the additional chemotherapy group, the mean PFS was 103.4 months (95 % CI 84.9-121.9 months) and the OS was 137.3 months (95 % CI 127.9-146.7 months). There was no difference between the two groups in OS (p = 0.836) and PFS (p = 0.695). Local stage MZL has a good clinical course and is well controlled with a local treatment modality without additional chemotherapy.

摘要

尽管局限性分期(Ann Arbor分期I/II期)的边缘区淋巴瘤(MZL)通过基于局部治疗的疗法能得到很好的控制,但关于I/II期MZL局部治疗后加用化疗的作用尚无数据。本研究纳入经活检确诊确诊的Ann Arbor分期I/II期MZL的患者(n = 210)进行分析。其中,180例患者(85.7%)为I期,30例(14.3%)为II期。大多数患者(n = 182,86.7%)接受了包括放疗或手术在内的局部治疗方式,28例(13.3%)在局部治疗后接受了额外的全身化疗。总缓解率为98.3%(95%CI 96 - 100%),其中187例完全缓解,20例部分缓解。在局部治疗组中,平均无进展生存期(PFS)为147.4个月(95%CI 126.7 - 168.1个月),总生存期(OS)为188.2个月(95%CI 178.8 - 197.7个月)。在加用化疗组中,平均PFS为103.4个月(95%CI 84.9 - 121.9个月),OS为137.3个月(95%CI 127.9 - 146.7个月)。两组在OS(p = 0.836)和PFS(p = 0.695)方面无差异。局限性分期的MZL具有良好的临床病程,通过局部治疗方式无需加用化疗即可得到很好的控制。

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