Objective: To investigate the efficacy of RCDOP (Rituximab, cyclophosphamide, liposome doxorubicin, vincristine and prednisone) regimen in patients with de novo diffuse large B-cell lymphoma (DLBCL), especially in those patients with multiple extra-nodal involvement or Bulky diseases. Methods: A total of 87 newly diagnosed DLBCL patients who received RCDOP regimen from October 2012 to October 2017 were enrolled into this study. Survival functions were estimated using the Kaplan-Meier method and compared by the log-rank test, and χ(2) tests were used for categorical data. Results: Among the 87 DLBCL patients treated with RCDOP regimen, 81 patients achieved complete remission (CR) or partial remission (PR), with ORR as 93.1%. Patients were further classified into groups, according to the risk factors, such as IPI scores, multiple extra-nodal involvement, bulky disease, age>60, tumor Ki-67>80%, elevated serum LDH level and advanced Ann Arbor stage. The progression-free survival (PFS, P=0.084) and overall survival (OS, P=0.515) had no statistical difference among the IPI low risk (0-1 score) group, intermediate risk (2-3 scores) group and high risk (4-5 scores) group. Similarly, no statistical difference were fou nd in PFS and OS of patients with extra-nodal involvements ≥2 (P=0.303 and P=0.624), with bulky disease (P=0.518 and P=0.466), with age>60 (P=0.600 and P=0.183), with elevated serum LDH level (P=0.054 and P=0.880), with advanced Ann Arbor stage (P=0.075 and P=0.286), and with tumor Ki-67 over 80% (P=0.190 and P=0.109), when compared with those of patients without these risk factors. Conclusion: RCDOP can improve the therapeutic effect and prognosis of DLBCL patients with certain high risk factors, such as intermediate and high IPI risks, multiple extra-nodal involvements, bulky disease, age over 60, elevated LDH level, advanced Ann Arbor stage and tumor Ki-67 over 80%.
目的: 评估RCDOP(利妥昔单抗、环磷酰胺、脂质体多柔比星、长春新碱、泼尼松)方案在弥漫大B细胞淋巴瘤(DLBCL)患者中的疗效。 方法: 回顾性分析2012年10月至2017年10月应用RCDOP方案治疗的87例初治DLBCL患者资料,结合临床特征进行疗效和生存分析。 结果: ①87例患者中,男40例,女47例,中位年龄60(14~84)岁。应用RCDOP方案治疗后,获得完全缓解(CR)和部分缓解(PR)者共计81例(93.10%)。②根据IPI评分不同危险度分层(低、中、高危)、结外累及部位(0~1个/≥2个)、肿块大小(<7.5 cm≥7.5 cm)、年龄(≤60岁/>60岁)、LDH(正常/升高)、Ann Arbor分期(Ⅰ~Ⅱ期/Ⅲ~Ⅳ期)、Ki-67阳性率(>80%/≤80%)对患者进行分组,比较组间无进展生存(PFS)和总生存(OS)的差异。结果显示,RCDOP方案治疗后,中位随访时间为9个月,IPI评分低、中、高危三组患者的1年PFS率(P=0.084)和OS率(P=0.515)差异无统计学意义,其余组间比较患者的1年PFS率和OS率差异也均无统计学意义(P值均>0.05)。 结论: RCDOP方案可以改善IPI评分中高危、结外多部位累及、巨大肿块、年龄>60岁、高LDH、Ann Arbor分期Ⅲ~Ⅳ期和Ki-67阳性率>80%患者的早期疗效。.
Keywords: Antineoplastic combined chemotherapy protocols; Lymphoma, large B-cell, diffuse; Prognosis; Tumor burden.