a Department of Oncology , Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine , Baltimore , MD , USA.
b Division of Biostatistics , Johns Hopkins University School of Medicine , Baltimore , MD , USA.
Leuk Lymphoma. 2019 May;60(5):1261-1265. doi: 10.1080/10428194.2018.1519812. Epub 2019 Jan 18.
Prior to the introduction of rituximab, primary mediastinal B-cell lymphoma (PMBCL) had high rates of treatment failure with cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP), prompting the use of consolidative mediastinal radiation or more intensive chemotherapy regimens. Cure rates improved dramatically with rituximab, but mediastinal radiation was still commonly employed with R-CHOP. We performed a retrospective review of patients treated with R-CHOP alone without radiation for PMBCL. Of 43 patients with PMBCL, 16 received R-CHOP alone. High-risk factors included 56% with bulky disease, 75% with elevated LDH, 25% with SVC syndrome, and 13% with stage IV disease. Three-year progression-free survival (PFS) and overall survival (OS) were 93% and 100% respectively. These results suggest that R-CHOP alone has a high cure rate in PMBCL while avoiding the side effects of mediastinal radiation.
在利妥昔单抗问世之前，环磷酰胺、多柔比星、长春新碱和泼尼松（CHOP）治疗原发性纵隔 B 细胞淋巴瘤（PMBCL）的失败率很高，这促使人们使用纵隔巩固性放疗或更强化的化疗方案。利妥昔单抗的应用使治愈率显著提高，但 R-CHOP 方案仍常联合纵隔放疗。我们对单独接受 R-CHOP 治疗而未接受放疗的 PMBCL 患者进行了回顾性研究。在 43 例 PMBCL 患者中，有 16 例仅接受 R-CHOP 治疗。高危因素包括 56%的患者存在肿块较大，75%的患者乳酸脱氢酶升高，25%的患者存在上腔静脉综合征，13%的患者存在 IV 期疾病。3 年无进展生存率（PFS）和总生存率（OS）分别为 93%和 100%。这些结果表明，R-CHOP 单独治疗 PMBCL 的治愈率很高，同时避免了纵隔放疗的副作用。
