| 一线序贯含铂方案治疗年轻弥漫大B 细胞淋巴瘤的临床研究 |
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| 引用本文： | 张培培, 李俊波, 姚志华, 姚书娜, 王海英, 徐原林, 褚俊峰, 刘艳艳. 一线序贯含铂方案治疗年轻弥漫大B 细胞淋巴瘤的临床研究[J]. 中国肿瘤临床, 2016, 43(14): 626-630. DOI: 10.3969/j.issn.1000-8179.2016.14.486 |
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| 作者姓名： | 张培培 李俊波 姚志华 姚书娜 王海英 徐原林 褚俊峰 刘艳艳 |
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| 作者单位： | 作者单位:郑州大学附属肿瘤医院淋巴综合内科(郑州市450008) |
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| 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，χ2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（over all 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。
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| 关 键 词： | 弥漫大B 细胞淋巴瘤 一线治疗 年轻 |
| 收稿时间： | 2016-04-27 |
| 修稿时间： | 2016-06-02 |
Clinical study on sequential platinum regimen as primary therapy for young patients with diffuse large B-cell lymphoma |
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| Peipei ZHANG, Junbo LI, Zhihua YAO, Shuna YAO, Haiying WANG, Yuanlin XU, Junfeng CHU, Yanyan LIU. Clinical study on sequential platinum regimen as primary therapy for young patients with diffuse large B-cell lymphoma[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2016, 43(14): 626-630. DOI: 10.3969/j.issn.1000-8179.2016.14.486 |
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| Authors: | Peipei ZHANG Junbo LI Zhihua YAO Shuna YAO Haiying WANG Yuanlin XU Junfeng CHU Yanyan LIU |
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| Affiliation: | Department of Lymphatic Medical Oncology, Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou 450008, China |
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| Abstract: | 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 usingχ2 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. |
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| Keywords: | diffuse large B-cell lymphoma primary therapy young |
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