Rožman Samo, Jezeršek Novaković Barbara, Ružić Gorenjec Nina, Novaković Srdjan
Pharmacy Department, Institute of Oncology Ljubljana, 1000 Ljubljana, Slovenia.
The Department of Lymphoma Treatment, Division of Medical Oncology, Institute of Oncology Ljubljana, 1000 Ljubljana, Slovenia.
Oncol Lett. 2022 Jul 19;24(3):320. doi: 10.3892/ol.2022.13440. eCollection 2022 Sep.
The present retrospective study was undertaken to investigate the association of relative dose intensity (RDI) with the outcome of patients with advanced stage Hodgkin lymphoma (HL) receiving ABVD (doxorubicin, bleomycin, vinblastine, dacarbazine) and escalated BEACOPP regimens (bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, prednisone). A total of 114 patients with HL treated between 2004 and 2013 were enrolled for evaluation. The association of variables with overall survival (OS) and progression-free survival (PFS) was analysed using univariate and multivariate Cox proportional hazards models. The median age of patients was 39 years, and the majority were male and had stage IV disease. A total of 54 patients received ABVD and 60 received BEACOPP chemotherapy with 24 and four deaths, respectively. Patients in the BEACOPP group were significantly younger with lower Charlson comorbidity index (CCI) and better performance status in comparison with the ABVD group, making the comparison of groups not possible. In the ABVD group, RDI was not significantly associated with OS (P=0.590) or PFS (P=0.354) in a multivariate model where age was controlled. The low number of events prevented this analysis in the BEACOPP group. The age of patients was strongly associated with both OS and PFS; all statistically significant predictors for OS and PFS from univariate analyses (chemotherapy regimen, CCI, RDI, performance status) lost their effect in multivariate analyses where age was controlled. Based on these observations, it was concluded that RDI was not associated with OS or PFS after age is controlled, neither in all patients combined nor in the ABVD group.
本回顾性研究旨在调查相对剂量强度(RDI)与晚期霍奇金淋巴瘤(HL)患者接受ABVD(阿霉素、博来霉素、长春花碱、达卡巴嗪)和强化BEACOPP方案(博来霉素、依托泊苷、阿霉素、环磷酰胺、长春新碱、丙卡巴肼、泼尼松)治疗结果之间的关联。共纳入2004年至2013年间接受治疗的114例HL患者进行评估。使用单因素和多因素Cox比例风险模型分析变量与总生存期(OS)和无进展生存期(PFS)之间的关联。患者的中位年龄为39岁,大多数为男性,且处于IV期疾病。共有54例患者接受ABVD治疗,60例接受BEACOPP化疗,分别有24例和4例死亡。与ABVD组相比,BEACOPP组患者明显更年轻,Charlson合并症指数(CCI)更低,体能状态更好,因此无法进行组间比较。在ABVD组中,在控制年龄的多因素模型中,RDI与OS(P=0.590)或PFS(P=0.354)无显著关联。事件数量较少,无法在BEACOPP组进行此分析。患者年龄与OS和PFS均密切相关;单因素分析中所有对OS和PFS有统计学意义的预测因素(化疗方案、CCI、RDI、体能状态)在控制年龄的多因素分析中均失去作用。基于这些观察结果,得出结论:在控制年龄后,RDI与OS或PFS均无关联,无论是在所有患者合并分析中还是在ABVD组中。