Department of Clinical Oncology, Ehime University School of Medicine, Toon, Japan.
Medical Profession Division, Ehime University Hospital, Toon, Japan.
Int J Clin Oncol. 2018 Apr;23(2):375-381. doi: 10.1007/s10147-017-1202-2. Epub 2017 Oct 24.
Follicular lymphoma (FL) is the most common type of non-Hodgkin lymphoma (NHL), with indolent progression. Several treatment options are selected, based not only on disease status, quality of life (QOL), and age of patient, but also on recent increasing medical costs. We retrospectively analysed the first-line treatment of FL with regard to treatment outcomes and medical economics, and discuss the appropriate strategies for FL.
Data on a total of 69 newly-diagnosed patients with FL was retrospectively collected from 2001 to 2015.
The median age of the patients was 60 years and the median follow-up was 58 months. A total of 25 cases with FL were treated with R monotherapy, and 28 cases were treated with R-CHOP as first-line treatment. The factors affecting the decision of physicians to use R or R-CHOP treatment were serum level of lactate dehydrogenase (LDH) and disease stage. The first-line treatment-associated survival did not show any statistical differences between R and R-CHOP. The average hospitalization and average of all medical costs during the first-line treatment were 4.1 days (R) versus 55.7 days (R-CHOP), and JPY 1,707,693 (USD 15,324) (R) versus JPY 2,136,117 (USD 19,170) (R-CHOP), respectively.
R monotherapy for patients whose diseases show low tumor burden and who are not candidates for local treatment has benefits as a first-line treatment compared to R-CHOP, based on the patients' QOL and medical economics.
滤泡性淋巴瘤（FL）是最常见的非霍奇金淋巴瘤（NHL），其进展缓慢。根据疾病状态、生活质量（QOL）和患者年龄，选择了几种治疗方案，同时也考虑到最近医疗费用的增加。我们回顾性分析了 FL 的一线治疗，以探讨其治疗效果和医学经济学，并讨论 FL 的适宜策略。
从 2001 年至 2015 年，我们回顾性地收集了总共 69 例新诊断的 FL 患者的数据。
患者的中位年龄为 60 岁，中位随访时间为 58 个月。共有 25 例 FL 患者接受 R 单药治疗，28 例患者接受 R-CHOP 作为一线治疗。影响医生决定使用 R 或 R-CHOP 治疗的因素是血清乳酸脱氢酶（LDH）水平和疾病分期。R 和 R-CHOP 一线治疗相关的生存没有统计学差异。R 和 R-CHOP 的平均住院时间和一线治疗的平均总医疗费用分别为 4.1 天（R）和 55.7 天（R-CHOP），JPY 1707693（USD 15324）（R）和 JPY 2136117（USD 19170）（R-CHOP）。
对于那些疾病负担低且不适合局部治疗的患者，R 单药治疗在 QOL 和医学经济学方面具有优于 R-CHOP 的一线治疗优势。
