Diggs C H, Wiernik P H, Ostrow S S
Cancer Clin Trials. 1981;4(2):107-14.
Forty previously untreated patients with either nodular poorly differentiated lymphocytic or nodular mixed lymphocytic/histiocytic non-Hodgkin's lymphoma were evaluated for length of survival from the onset of combination chemotherapy. Complete remissions from initial therapy were achieved in 27/40 patients (67.5%). Actuarial analysis of survival shows that 83% of the complete responders from initial treatment are expected to be living at 7 years in contrast to a less than 2-year median survival of those who failed to reach complete remission with initial therapy when deaths from nonlymphomatous causes are excluded. Wilcoxon comparison of these curves shows a significant (p = 0.0001) advantage for those who are able to attain a complete remission. Treatment was not implicated in any death. Of those patients not reaching complete remission from initial therapy, 80% of the survivors attained a complete response from other therapy. It is concluded that complete remission attainment from initial chemotherapy significantly prolongs survival for patients with nodular lymphoma. Therefore, since combination chemotherapy has given higher complete remission rates than have single agents, such therapy offers the patient with nodular lymphoma the greatest chance for prolonged survival.
对40例既往未经治疗的结节性低分化淋巴细胞型或结节性混合淋巴细胞/组织细胞型非霍奇金淋巴瘤患者进行了联合化疗开始后的生存期评估。40例患者中有27例(67.5%)经初始治疗后达到完全缓解。生存的精算分析表明,初始治疗的完全缓解者中83%预计7年后仍存活,相比之下,排除非淋巴瘤原因导致的死亡后,初始治疗未能达到完全缓解者的中位生存期不到2年。对这些曲线进行Wilcoxon比较显示,能够达到完全缓解者具有显著优势(p = 0.0001)。治疗与任何死亡均无关联。初始治疗未达到完全缓解的患者中,80%的幸存者经其他治疗后达到完全缓解。得出的结论是,初始化疗达到完全缓解可显著延长结节性淋巴瘤患者的生存期。因此,由于联合化疗的完全缓解率高于单药治疗,这种治疗为结节性淋巴瘤患者提供了最长生存期的最大机会。