Zhang Limei, Huang He, Wang Zhao, Fang Xiaojie, Hong Huangming, Chen Yungchang, Li Fangfang, Yao Yuyi, Chen Zegeng, Pan Fei, Li Xiaoqian, Chen Meiting, Gale Robert Peter, Liang Yang, Lin Tongyu
Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, People's Republic of China.
Department of Hematologic Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Guangzhou, People's Republic of China.
Cancer Manag Res. 2021 Nov 25;13:8831-8839. doi: 10.2147/CMAR.S330273. eCollection 2021.
The management of primary intestinal diffuse large B cell lymphoma (PI-DLBCL) in elderly patients (aged >60 years) remains controversial. We conducted a retrospective study to assess the efficacy of different treatment strategies and prognostic factors for elderly Chinese patients with PI-DLBCL.
Forty-six untreated elderly patients with PI-DLBCL were included in this retrospective study. Twenty-four patients were treated with surgery (prior to chemotherapy) plus chemotherapy (SCT). The other 22 patients did not undergo surgery before chemotherapy (CT).
Patients treated with SCT had a higher overall response rate of 91.7% than patients receiving CT, but the difference between groups was not significant (=0.581). Regarding survival, SCT resulted in a greater 3-year overall survival (OS) rate (87.3% vs 56.9%, =0.130) and significantly higher 3-year event-free survival (EFS) rate (74.1% vs 27.3%, =0.002) than CT. The univariate analysis showed that male sex, advanced Lugano stage, poor performance status and chemotherapy alone were associated with a shorter EFS. Only the male sex was correlated with a shorter OS. The multivariate analysis showed that sex (=0.040) and treatment strategy (=0.022) were independent prognostic factors for EFS.
Surgery plus chemotherapy produced a better outcome for EFS, but not OS, than chemotherapy alone in elderly Chinese patients with PI-DLBCL.
老年患者（年龄>60岁）原发性肠道弥漫性大B细胞淋巴瘤（PI-DLBCL）的治疗仍存在争议。我们进行了一项回顾性研究，以评估不同治疗策略对中国老年PI-DLBCL患者的疗效及预后因素。
本回顾性研究纳入了46例未经治疗的老年PI-DLBCL患者。24例患者接受手术（化疗前）加化疗（SCT）。另外22例患者在化疗前未接受手术（CT）。
接受SCT治疗的患者总缓解率为91.7%，高于接受CT治疗的患者，但两组间差异无统计学意义（P=0.581）。在生存方面，SCT组的3年总生存率（OS）更高（87.3%对56.9%，P=0.130），3年无事件生存率（EFS）显著高于CT组（74.1%对27.3%，P=0.002）。单因素分析显示，男性、卢加诺分期晚期、体能状态差和单纯化疗与较短的EFS相关。只有男性与较短的OS相关。多因素分析显示，性别（P=0.040）和治疗策略（P=0.022）是EFS的独立预后因素。
对于中国老年PI-DLBCL患者，手术加化疗在EFS方面的结局优于单纯化疗，但在OS方面并非如此。
