高龄弥漫性大 B 细胞淋巴瘤患者的最佳治疗选择：系统综述
Diffuse large B-cell lymphoma in very elderly patients: Towards best tailored treatment - A systematic review.
机构信息
Department of Medical Oncology, Hospital Pedro Hispano, Matosinhos Local Health Unit, Matosinhos, Portugal.
Department of Onco-Hematology, Portuguese Institute of Oncology of Porto, Porto, Portugal.
出版信息
Crit Rev Oncol Hematol. 2021 Apr;160:103294. doi: 10.1016/j.critrevonc.2021.103294. Epub 2021 Mar 3.
INTRODUCTION
Diffuse large B cell Lymphoma (DLBCL) is a potentially curative lymphoma with increasing incidence with ageing. Treatment of elderly DLBCL patients represents a particular challenge due to their comorbidities and performance status.
METHODS
A search for original articles focused on the treatment of elderly DLBCL patients was performed in PubMed database and 633 were found and reviewed. Thirty-eight studies meeting our inclusion criteria were published since 2007.
RESULTS
Thirteen studies were retrospective and 25 phase II/III clinical trials. Most of them investigated the efficacy of dose-adjusted R-CHOP regimen. Alternative therapeutic drugs together with geriatric assessment were also evaluated. For fit patients aged 80 and over, the strongest evidence favours R-miniCHOP regimen.
CONCLUSION
A dose-adjusted R-CHOP may be the recommended treatment in elderly DLBCL patients. New tools such as the Comprehensive Geriatric Assessment provide useful guidance for treatment choice, based on comorbidities and frailty index of this group.
简介
弥漫性大 B 细胞淋巴瘤（DLBCL）是一种具有潜在治愈性的淋巴瘤，随着年龄的增长发病率不断上升。由于老年 DLBCL 患者存在合并症和身体状况，其治疗具有一定的挑战性。
方法
在 PubMed 数据库中进行了针对老年 DLBCL 患者治疗的原始文章检索，共检索到 633 篇文章并进行了综述。自 2007 年以来，发表了 38 项符合我们纳入标准的研究。
结果
其中 13 项为回顾性研究，25 项为 II/III 期临床试验。它们大多研究了剂量调整的 R-CHOP 方案的疗效。同时也评估了替代治疗药物和老年综合评估。对于年龄在 80 岁及以上的身体状况良好的患者，R-miniCHOP 方案是最有力的证据支持。
结论
对于老年 DLBCL 患者，剂量调整的 R-CHOP 可能是推荐的治疗方法。新的工具，如全面老年评估，为基于该组患者的合并症和虚弱指数的治疗选择提供了有用的指导。
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