Issa Djamila E, Dinmohamed Avinash G, Wondergem Marielle J, Blommestein Hedwig M, Huijgens Peter C, Lugtenburg Pieternella J, Visser Otto, Zweegman Sonja, Chamuleau Martine E D
Department of Hematology, Cancer Center Amsterdam, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
Department of Hematology, Jeroen Bosch Hospital, 's-Hertogenbosch, The Netherlands.
Leuk Lymphoma. 2021 Mar;62(3):549-559. doi: 10.1080/10428194.2020.1842394. Epub 2020 Nov 19.
Randomized controlled trials have studied different dose-intensity and dose-interval regimens of R-CHOP for patients with diffuse large B-cell lymphoma (DLBCL). This study was undertaken to confirm these results in a population-based setting, with special emphasis on the value of 6xR-CHOP21 among patients aged 18-64 years. Two thousand three hundred and thirty-eight stage II-IV DLBCL patients, ≥18 years, we confirmed the similar efficacy of six versus eight cycles of R-CHOP and of R-CHOP21 versus R-CHOP14 regimens across all age groups on overall survival (median follow-up 36.4 (1.3-167.6) months). Nevertheless, overall survival decreased with older age. Interestingly, in patients 18-64 years, the adjusted risk of mortality among recipients of 6xR-CHOP21 compared to other R-CHOP regimens seems to be similar (HR 0.62; 95%CI: 0.38-1.02; = .059). Although this finding might suggest that 6xR-CHOP21 could be considered as first-line regimen for all stage II-IV DLBCL patients, it should be confirmed in forthcoming population-based studies with larger patient numbers and longitudinal follow-up.
随机对照试验研究了弥漫性大B细胞淋巴瘤（DLBCL）患者使用R-CHOP的不同剂量强度和剂量间隔方案。本研究旨在在基于人群的环境中证实这些结果，特别强调6xR-CHOP21在18至64岁患者中的价值。2338例年龄≥18岁的II-IV期DLBCL患者，我们证实在所有年龄组中，R-CHOP六个周期与八个周期以及R-CHOP21与R-CHOP14方案在总生存期方面疗效相似（中位随访36.4（1.3 - 167.6）个月）。然而，总生存期随年龄增长而降低。有趣的是，在18至64岁的患者中，与其他R-CHOP方案相比，接受6xR-CHOP21治疗者的校正死亡风险似乎相似（风险比0.62；95%置信区间：0.38 - 1.02；P = 0.059）。尽管这一发现可能表明6xR-CHOP21可被视为所有II-IV期DLBCL患者的一线方案，但仍需在即将开展的、纳入更多患者并进行长期随访的基于人群的研究中得到证实。
