摘要
目的：回顾性分析一线序贯含铂方案治疗年轻弥漫大B细胞淋巴瘤（diffuse large B-cell Lymphoma,DLBCL）的疗效和安全性。方法：选择郑州大学附属肿瘤医院2005年1月至2012年6月收治的、符合入组标准的年轻初治DLBCL患者,分为标准方案和序贯含铂方案组,χ~2检验比较两组的缓解率,Kaplan-Meier生存分析比较两组的5年生存率,Cox回归多因素分析生存相关影响因素,亚组分析序贯含铂方案最佳获益人群。结果：入组331例患者,包括序贯含铂方案129例和标准方案202例。序贯含铂方案较标准方案获得较高的完全缓解率（complete remission rate,CRR）（80%vs.63%,P=0.001）,较高的5年无进展生存（progression free survival,PFS）（60%vs.50%,P=0.014）和总生存（overall survival,OS）（70%vs.58%,P=0.016）。多因素生存分析显示序贯含铂方案治疗是PFS（HR=0.635,P=0.012）和总OS（HR=0.625,P=0.021）独立的影响因素。亚组分析显示预后良好和未联合应用利妥昔单抗的患者是序贯含铂方案的最佳获益人群。两组不良反应发生无显著性差异。结论：一线序贯含铂方案能够改善年轻DLBCL患者的疗效,且安全性好;预后良好和未联合应用利妥昔单抗的患者是最佳获益人群。
Objective： To evaluate the efficacy and safety of sequential platinum regimen in young patients with diffuse large B-cell lym- phoma （DLBCL）. Methods： Newly diagnosed young patients with DLBCL, who were hospitalized from January 2005 to June 2012 in the Affiliated Cancer Hospital of Zhengzhou University, were selected according to the requirements. The patients were divided into stan- dard and sequential platinum regimen groups. The remission rates were compared using y,2 test, whereas the five-year survival rates between the two groups were compared using the Kaplan Meier method. Multivariate survival analysis was performed using the Cox proportional regression. Subgroup analysis was conducted to select candidate patients for the sequential platinum regimen. Results： A total of 331 patients were enrolled in the study, in which 129 were provided with sequential platinum regimen and 202 were provided with the standard regimen. Sequential regimen yielded higher rates of complete remission （80% vs. 63%, P=0.001）, five-year progres- sion-free survival （PFS; 60% vs. 50%, P=0.014）, and overall survival （OS; 70% vs. 58%, P=0.016） than the standard regimen. Multivariate analysis revealed that sequential regimen was an independent prognostic factor for PFS （hazard ratio HR=0.635, P=0.012） and OS （HR=0.625, P=0.021）. Subgroup analysis showed that patients with good prognosis and patients who did not receive rituximab benefited more from the sequential platinum regimen. Sequential platinum regimen did not increase the occurrence of adverse effects com- pared with the standard regimen. Conclusion： Sequential platinum regimen is a safe treatment that can improve the survival of young patients with DLBCL. Patients with good prognosis and patients who did not receive rituximab can benefit more from the treatment with sequential platinum regimen.
出处
《中国肿瘤临床》
CAS
CSCD
北大核心
2016年第14期626-630,共5页
Chinese Journal of Clinical Oncology
关键词
弥漫大B细胞淋巴瘤
一线治疗
年轻
diffuse large B-cell lymphoma, primary therapy, young
作者简介
张培培 专业方向为淋巴瘤基础与临床研究。E-mail：zzuzhangpei@163．com
刘艳艳，主任医师，博士研究生导师，上海交通大学内科学博士，美国Nebraska大学医学中心博士后。现任郑州大学附属肿瘤医院内科副主任，淋巴综合内科负责人，河南省肿瘤研究院淋巴瘤研究所所长，河南省学术技术带头人。中华医学会肿瘤学分会青年委员，中国医师协会肿瘤医师分会青年委员，河南省抗癌协会淋巴瘤专业委员会副主任委员，河南省抗癌协会化疗专业青年委员会副主任委员。主要从事恶性淋巴瘤、多发性骨髓瘤、乳腺癌、胃肠道等恶性肿瘤的规范化、个体化治疗和临床转化研究。主持国家自然科学基金面上项目3项，河南省科技攻关项目3项，在BLOOD、eLIFE、Leukemia ＆ Lymphoma、Journal 0f Hematology＆ Oneology等国内外期刊发表论著10余篇，获河南省医学科技进步奖3项，获河南省肿瘤医院、肿瘤研究院首批医学科技拔尖人才、河南省卫生系统出国研修先进个人、河南省优秀中青年科技创新型人才等称号。通信作者：刘艳艳yyliu@zzu．edu．cn
