Meerwaldt J H, Carde P, Somers R, Thomas J, Kluin-Nelemans J C, Bron D, Noordijk E M, Cosset J M, Bijnens L, Teodorovic I, Hagenbeek A
Medisch Spectrum Twente, Enschede, The Netherlands.
Ann Oncol. 1997;8 Suppl 1:67-70.
CHOP has been and still is regarded by many as the 'standard' treatment of advanced non-Hodgkin's lymphoma. In 1980 the EORTC Lymphoma Cooperative Group started a study to evaluate the addition of vincristine and bleomycin to its standard four-drug combination chemotherapy, CHVmP (cyclophosphamide, hydroxorubicin, Vm-26, prednisone). Eligible patients were stage III or IV, intermediate- to high-grade non-Hodgkin's lymphoma (Working Formulation E-I). One-hundred-eighty-nine patients were entered, of whom 140 were eligible and evaluable. A previous report showed an improved response rate and failure-free survival (FFS) and overall survival for the combination CHVmP-VB. At ten years, the outcome still favors the addition of vincristine and bleomycin. The FFS was 34% vs. 23% and the overall survival 34% vs 22%. This difference was mainly due to a difference in CR rate (74% vs. 49%), Relapse-free survival for patients reaching a CR was the same in both arms. When the patients were grouped according to the International Prognostic Factor Index, no statistically significant difference could be observed in favor of one treatment within either group. This trial clearly demonstrates the benefit gained by the addition of vincristine and bleomycin to 'standard' chemotherapy for intermediate and high-grade non-Hodgkin's lymphoma.
CHOP一直且至今仍被许多人视为晚期非霍奇金淋巴瘤的“标准”治疗方案。1980年，欧洲癌症研究与治疗组织（EORTC）淋巴瘤协作组启动了一项研究，以评估在其标准的四药联合化疗方案CHVmP（环磷酰胺、羟基柔红霉素、威猛（Vm-26）、泼尼松）中加入长春新碱和博来霉素的效果。符合条件的患者为Ⅲ期或Ⅳ期、中高级别非霍奇金淋巴瘤（工作分类E-I）。共有189例患者入组，其中140例符合条件且可评估。之前的一份报告显示，CHVmP-VB联合方案的缓解率、无进展生存期（FFS）和总生存期均有所改善。十年时，结果仍有利于加入长春新碱和博来霉素。无进展生存期分别为34%和23%，总生存期分别为34%和22%。这种差异主要是由于完全缓解（CR）率的差异（74%对49%），两组中达到CR的患者的无复发生存期相同。当根据国际预后因素指数对患者进行分组时，在任何一组内均未观察到有利于一种治疗的统计学显著差异。该试验清楚地证明了在中高级别非霍奇金淋巴瘤的“标准”化疗中加入长春新碱和博来霉素所带来的益处。
