Department of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Leuk Lymphoma. 2023 Dec;64(14):2258-2268. doi: 10.1080/10428194.2023.2256908. Epub 2023 Sep 14.
We conducted a population-based study of patients >65 years, diagnosed 2008-2017, with peripheral T-cell lymphoma (PTCL) using SEER-Medicare. Associations between PTCL subtype, treatment regimen, comorbidity, and mortality were assessed using the Kaplan-Meier method and multivariable Cox regression. Amongst the 2,546 patients, the median age was 77 years (interquartile range, 71-83). 5-year overall survival (OS) ranged from 22.2% to 37.3% depending on PTCL subtype. The most common frontline regimen was cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP). 5-year OS rate was 47.0% for patients treated with etoposide + CHOP ( = 67; CHOEP), 33.7% for those treated with CHOP ( = 732), and 23.8% for patients treated with non-anthracycline-containing regimens ( = 105; < 0.001). In patients without comorbidities, CHOEP remained independently associated with improved OS (HR 0.52, 95% CI,0.30-0.91). Median OS was 1.2 years from initiation of second-line therapy ( = 228) independent of treatment regimen. Frontline but not second-line treatment regimen is associated with OS in older patients with PTCL.
我们利用 SEER-Medicare 数据库对 2008 年至 2017 年间被诊断患有外周 T 细胞淋巴瘤(PTCL)的年龄大于 65 岁的患者进行了一项基于人群的研究。使用 Kaplan-Meier 方法和多变量 Cox 回归评估了 PTCL 亚型、治疗方案、合并症和死亡率之间的关系。在 2546 名患者中,中位年龄为 77 岁(四分位间距,71-83)。根据 PTCL 亚型,5 年总生存率(OS)范围为 22.2%-37.3%。最常见的一线治疗方案是环磷酰胺、多柔比星、长春新碱和泼尼松(CHOP)。接受依托泊苷+CHOP(=67;CHOEP)治疗的患者 5 年 OS 率为 47.0%,接受 CHOP(=732)治疗的患者为 33.7%,接受不含蒽环类药物的方案(=105)治疗的患者为 23.8%(<0.001)。在无合并症的患者中,CHOEP 与改善的 OS 仍然独立相关(HR 0.52,95%CI,0.30-0.91)。二线治疗开始后,中位 OS 为 1.2 年(=228),与治疗方案无关。在老年 PTCL 患者中,一线治疗方案而非二线治疗方案与 OS 相关。