R-CHOP 与 R-CHOEP 治疗高危弥漫性大 B 细胞淋巴瘤青年患者的疗效：一项丹麦观察性基于人群的研究。
Effectiveness of R-CHOP versus R-CHOEP for treatment of young patients with high-risk diffuse large B-cell lymphoma: A Danish observational population-based study.
机构信息
Department of Hematology, Clinical Cancer Research Centre, Aalborg University Hospital, Aalborg, Denmark.
Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
出版信息
Eur J Haematol. 2024 Nov;113(5):641-650. doi: 10.1111/ejh.14275. Epub 2024 Jul 22.
PURPOSE
Etoposide to standard R-CHOP is used for high-risk diffuse large B-cell lymphoma (DLBCL) in some countries. Due to the lack of randomized trials, a real-world data study using matching methods was used to test the potential effectiveness of R-CHOEP over R-CHOP.
PATIENTS AND METHODS
This study included patients from the Danish Lymphoma Register diagnosed between 2006 and 2020 at the age of 18-60 years with de novo DLBCL and age-adjusted IPI ≥2. R-CHOEP treated patients were matched 1:1 without replacement to R-CHOP treated patients using a hybrid exact and genetic matching technique. Primary endpoints were progression-free survival (PFS) and overall survival (OS).
RESULTS
In total, 396 patients were included; 213 received R-CHOEP and 183 received R-CHOP. Unadjusted 5-year PFS and OS for R-CHOEP were 69% (95% Confidence intervals [CI]; 63%-76%) and 79% (CI;73%-85%) versus 62% (CI;55%-70%) and 76% (CI;69%-82%) for R-CHOP (log-rank test, PFS p = .25 and OS p = .31). A total of 127 patients treated with R-CHOEP were matched to 127 patients treated with R-CHOP. Matching-adjusted 5-year PFS and OS were 65% (CI; 57%-74%) and 79% (CI; 72%-84%) for R-CHOEP versus 63% (CI; 55%-73%) and 79% (CI;72%-87%) for R-CHOP (log-rank test, PFS p = .90 and OS p = .63).
CONCLUSION
The present study did not confirm superiority of R-CHOEP over R-CHOP for young patients with high-risk DLBCL.
目的
在一些国家，依托泊苷联合标准 R-CHOP 用于高危弥漫性大 B 细胞淋巴瘤（DLBCL）。由于缺乏随机试验，本研究使用匹配方法的真实世界数据研究旨在检验 R-CHOEP 相对于 R-CHOP 的潜在有效性。
患者和方法
本研究纳入了 2006 年至 2020 年期间在丹麦淋巴瘤登记处诊断为初治、年龄 18-60 岁、调整年龄后的国际预后指数（IPI）≥2 的弥漫性大 B 细胞淋巴瘤患者。采用混合精确和遗传匹配技术，将 R-CHOEP 治疗的患者与接受 R-CHOP 治疗的患者 1:1 进行无替换匹配。主要终点是无进展生存期（PFS）和总生存期（OS）。
结果
共纳入 396 例患者，其中 213 例接受 R-CHOEP 治疗，183 例接受 R-CHOP 治疗。R-CHOEP 组未经调整的 5 年 PFS 和 OS 为 69%（95%置信区间[CI]：63%-76%）和 79%（CI：73%-85%），而 R-CHOP 组为 62%（CI：55%-70%）和 76%（CI：69%-82%）（对数秩检验，PFS p=0.25，OS p=0.31）。共有 127 例接受 R-CHOEP 治疗的患者与 127 例接受 R-CHOP 治疗的患者进行了匹配。匹配调整后的 5 年 PFS 和 OS 分别为 R-CHOEP 组的 65%（CI：57%-74%）和 79%（CI：72%-84%）和 R-CHOP 组的 63%（CI：55%-73%）和 79%（CI：72%-87%）（对数秩检验，PFS p=0.90，OS p=0.63）。
结论
本研究未证实 R-CHOEP 用于年轻高危 DLBCL 患者优于 R-CHOP。
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