Mocikova Heidi, Pytlik Robert, Sykorova Alice, Janikova Andrea, Prochazka Vit, Vokurka Samuel, Berkova Adela, Belada David, Campr Vit, Buresova Lucie, Trneny Marek
a Department for Internal Medicine and Haematology, Faculty Hospital Kralovske Vinohrady and Third Faculty of Medicine , Charles University in Prague , Czech Republic.
b First Medical Department - Clinical Department of Haemato-oncology , First Faculty of Medicine and General Teaching Hospital, Charles University in Prague , Czech Republic.
Leuk Lymphoma. 2016 Dec;57(12):2777-2783. doi: 10.3109/10428194.2016.1167203. Epub 2016 Apr 18.
We have investigated whether the addition of rituximab to methotrexate, procarbazine, vincristine, radiotherapy and cytarabine was associated with improved outcome of primary central nervous system lymphomas (PCNSL). Of 164 patients, 49 received rituximab. Median age was 63 years, median Karnofsky performance score (KPS) was 60 and median follow-up of living patients was 59.5 months. 1- and 2-year PFS were 49.7 and 37.9%, 1- and 2-year OS were 57.0 and 45.3%. Median progression-free survival (PFS), but not overall survival (OS) was significantly better for patients treated with rituximab (22.9 vs. 10.9 months, p = 0.037). In multivariate analysis, age ≤70 years and KPS ≥90 were predictive for PFS and OS, rituximab was an independent prognostic factor for PFS only. In landmark analyses, rituximab was not found beneficial for long-term survivors and no group particularly benefited from rituximab. In conclusion, addition of rituximab was associated with improved PFS, but not OS in this unselected cohort of PCNSL patients.
我们研究了在甲氨蝶呤、丙卡巴肼、长春新碱、放疗和阿糖胞苷基础上加用利妥昔单抗是否与原发性中枢神经系统淋巴瘤（PCNSL）的预后改善相关。164例患者中，49例接受了利妥昔单抗治疗。中位年龄为63岁，中位卡诺夫斯基体能状态评分（KPS）为60分，存活患者的中位随访时间为59.5个月。1年和2年无进展生存率（PFS）分别为49.7%和37.9%，1年和2年总生存率（OS）分别为57.0%和45.3%。接受利妥昔单抗治疗的患者中位无进展生存期（PFS）显著更长，但总生存期（OS）无显著差异（22.9个月对10.9个月，p = 0.037）。多因素分析中，年龄≤70岁和KPS≥90是PFS和OS的预测因素，利妥昔单抗仅是PFS的独立预后因素。在标志性分析中，未发现利妥昔单抗对长期生存者有益，也没有特定亚组从利妥昔单抗治疗中特别获益。总之，在这个未经选择的PCNSL患者队列中，加用利妥昔单抗与PFS改善相关，但与OS改善无关。
