I 期-II 期弥漫性大 B 细胞淋巴瘤，采用利妥昔单抗联合化疗，联合或不联合放疗。
Stage I-II diffuse large B-cell lymphoma treated with rituximab and chemotherapy with or without radiotherapy.
机构信息
Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA, USA.
Department of Pathology, Stanford University School of Medicine, Stanford, CA, USA.
出版信息
Leuk Lymphoma. 2021 Aug;62(8):1840-1849. doi: 10.1080/10428194.2021.1876859. Epub 2021 Feb 23.
We set to identify prognostic factors in a retrospective cohort of consecutive patients with stage I-II diffuse large B-cell lymphoma treated with rituximab-chemotherapy with or without radiotherapy from 2001 through 2017 at our institution. We identified 143 patients with median follow-up of 7.7 years. The majority were male (59.4%), had stage II (53.1%), had stage-modified IPI 0-1 (smIPI, 58.1%), and had non-bulky disease (<7 cm, 68.5%). 99 patients (69.2%) received rituximab-chemotherapy followed by radiotherapy, and 44 patients (30.8%) received rituximab-chemotherapy alone. The 5-year progression-free survival (PFS) and overall survival (OS) were 81.2% and 88.9%, respectively. The 5-year PFS for those with smIPI 0-1 versus 2-4 was 89.5% versus 69.7%, respectively ( = 0.005). Bulky disease (≥7 cm) was associated with worse PFS and OS on univariable and multivariable analyses ( < 0.05). Patients with smIPI 0-1 without bulky disease have excellent outcomes. However, patients with smIPI 2-4 or bulky disease have a high risk of progression.
我们旨在确定我们机构 2001 年至 2017 年间接受利妥昔单抗化疗联合或不联合放疗的 I 期- II 期弥漫性大 B 细胞淋巴瘤连续患者的回顾性队列中的预后因素。我们确定了 143 名患者，中位随访时间为 7.7 年。大多数患者为男性（59.4%），处于 II 期（53.1%），改良国际预后指数（IPI）0-1 期（smIPI，58.1%），非肿块性疾病（<7cm，68.5%）。99 名患者（69.2%）接受利妥昔单抗化疗联合放疗，44 名患者（30.8%）接受利妥昔单抗化疗。5 年无进展生存（PFS）和总生存（OS）分别为 81.2%和 88.9%。smIPI 0-1 期与 2-4 期患者的 5 年 PFS 分别为 89.5%和 69.7%（=0.005）。单变量和多变量分析均显示，肿块性疾病（≥7cm）与较差的 PFS 和 OS 相关（<0.05）。smIPI 0-1 期且无肿块性疾病的患者预后良好。然而，smIPI 2-4 期或肿块性疾病的患者进展风险较高。
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