对于Ⅰ期弥漫性大B细胞淋巴瘤患者，与单纯CHOP方案相比，添加利妥昔单抗未显示出生存获益。
Addition of rituximab is not associated with survival benefit compared with CHOP alone for patients with stage I diffuse large B-cell lymphoma.
作者信息
Jia Bo, Shi Yuankai, Kang Suyi, Yang Sheng, Hu Shaoxuan, Li Yexiong, Dong Mei, Wang Weihu, Yang Jianliang, Zhou Liqiang, Liu Peng, Zhou Shengyu, Qin Yan, Gui Lin, Zhang Changgong, Lin Hua, Chen Shanshan, Wang Lin, He Xiaohui
机构信息
1 Department of Medical Oncology, Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, Beijing 100021, China ; 2 Department of Radiation Oncology, 3 Department of Medical Record Library, Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100021, China.
出版信息
Chin J Cancer Res. 2015 Oct;27(5):516-23. doi: 10.3978/j.issn.1000-9604.2015.10.04.
BACKGROUND
The role of rituximab in combination with CHOP regimen in patients with stage I diffuse large B-cell lymphoma (DLBCL) remains to be defined. We aimed to compare CHOP plus rituximab (R-CHOP) with CHOP alone and determine the value of radiotherapy in these patients.
METHODS
Between 2003 and 2009, 140 untreated patients with stage I DLBCL were retrospectively analyzed in this study.
RESULTS
Seventy-eight patients were treated in R-CHOP group and 62 in CHOP group. Ninety-one patients received additional radiotherapy at the end of chemotherapy. The different treatment groups were well-balanced with respect to baseline characteristics. Complete response (CR) rate was 77% both in R-CHOP and CHOP groups (P=0.945). After a median follow-up period of 56 months, patients received R-CHOP regimen had similar 5-year progression-free survival (PFS) (76% vs. 85%; log-rank P=0.215) and 5-year overall survival (OS) (90% vs. 96%; log-rank P=0.175) compared with those with CHOP alone. Patients with radiotherapy had significantly increased 5-year PFS compared with those who had chemotherapy alone (86% vs. 71%; log-rank P=0.005). At multivariate analysis, patients who had CR (P=0.008) and received radiotherapy (P=0.003) were significantly associated with superior PFS.
CONCLUSIONS
CHOP alone could be as effective as R-CHOP regimen and additional radiotherapy would be necessary for stage I or stage I non-bulky DLBCL patients.
背景
利妥昔单抗联合CHOP方案在Ⅰ期弥漫性大B细胞淋巴瘤（DLBCL）患者中的作用尚待明确。我们旨在比较CHOP加利妥昔单抗（R-CHOP）与单纯CHOP方案，并确定放疗在这些患者中的价值。
方法
本研究对2003年至2009年间140例未经治疗的Ⅰ期DLBCL患者进行了回顾性分析。
结果
R-CHOP组治疗78例患者，CHOP组治疗62例患者。91例患者在化疗结束时接受了额外放疗。不同治疗组在基线特征方面均衡良好。R-CHOP组和CHOP组的完全缓解（CR）率均为77%（P=0.945）。中位随访56个月后，接受R-CHOP方案的患者与单纯接受CHOP方案的患者相比，5年无进展生存期（PFS）相似（76%对85%；对数秩检验P=0.215），5年总生存期（OS）相似（90%对96%；对数秩检验P=0.175）。接受放疗的患者与单纯接受化疗的患者相比，5年PFS显著提高（86%对71%；对数秩检验P=0.005）。多因素分析显示，达到CR（P=0.008）和接受放疗（P=0.003）的患者与更好的PFS显著相关。
结论
单纯CHOP方案与R-CHOP方案疗效相当，Ⅰ期或Ⅰ期非大包块型DLBCL患者需要额外放疗。
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