Zhang M C, Xu P P, Zhong H J, Zhao X, Zhao W L, Cheng S
Shanghai Institute of Hematology, Shanghai Rui Jin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, China.
Zhonghua Xue Ye Xue Za Zhi. 2017 Sep 14;38(9):772-777. doi: 10.3760/cma.j.issn.0253-2727.2017.09.008.
To validate the prognostic value of NCCN-International Prognostic Index (NCCN-IPI) for patients with peripheral T-cell lymphoma (PTCL) treated with CHOP-based chemotherapy. A retrospective analysis in 162 PTCL patients who were initially diagnosed and treated in Rui Jin Hospital from January 2003 to May 2013 was conducted. Baseline characteristics were collected, and survival analysis was performed according to the IPI and NCCN-IPI model. The estimated 5-year overall survival (OS) rate and progression free survival (PFS) rate were 33% and 20%, with median OS and PFS of 17.0 months and 9.2 months, respectively. Multivariate analysis indicated ECOG score (PFS: =2.418, 95% 1.535-3.809, <0.001; OS: =2.347, 95% 1.435-3.839, = 0.001) , specific extra-nodal sites (PFS: =1.800, 95% 1.216-2.665, =0.003; OS: =1.608, 95% 1.054-2.454, =0.027) and pathology type (PFS: =0.424, 95% 0.184-0.975, =0.043; OS: =0.276, 95% 0.087-0.877, =0.029) were independent prognostic factors of OS and PFS for the patients with PTCL. The survival rates of low risk patients based on NCCI-IPI were remarkably higher than the counterparts based on IPI (5-year OS 74% 54%, (2)=5.041, =0.025, 5-year PFS 50% 38%, (2)= 5.295, =0.021) . NCCN-IPI was outstanding to identify the subgroup of low risk patients with PTCL, who may benefit from conventional chemotherapy such as CHOP or CHOP-like regimen. NCCN-IPI is more powerful for low risk PTCL patients and a strong supplement for IPI.
为验证美国国立综合癌症网络国际预后指数（NCCN - IPI）对接受基于CHOP方案化疗的外周T细胞淋巴瘤（PTCL）患者的预后价值。对2003年1月至2013年5月在瑞金医院初诊并接受治疗的162例PTCL患者进行回顾性分析。收集基线特征，并根据IPI和NCCN - IPI模型进行生存分析。估计的5年总生存率（OS）和无进展生存率（PFS）分别为33%和20%，OS和PFS的中位数分别为17.0个月和9.2个月。多因素分析表明，ECOG评分（PFS：=2.418，95%置信区间1.535 - 3.809，<0.001；OS：=2.347，95%置信区间1.435 - 3.839，=0.001）、特定结外部位（PFS：=1.800，95%置信区间1.216 - 2.665，=0.003；OS：=1.608，95%置信区间1.054 - 2.454，=0.027）和病理类型（PFS：=0.424，95%置信区间0.184 - 0.975，=0.043；OS：=0.276，95%置信区间0.087 - 0.877，=0.029）是PTCL患者OS和PFS的独立预后因素。基于NCCI - IPI的低风险患者生存率显著高于基于IPI的患者（5年OS 74%对54%，(2)=5.041，=0.025；5年PFS 50%对38%，(2)=5.295，=0.021）。NCCN - IPI在识别PTCL低风险患者亚组方面表现出色，这些患者可能从CHOP或类似CHOP方案的传统化疗中获益。NCCN - IPI对低风险PTCL患者的预后评估能力更强，是IPI的有力补充。
