Long-term results of the R-CHOP study in the treatment of elderly patients with diffuse large B-cell lymphoma:: A study by the groupe d'Etude des lymphomes de l'adulte
Long-term results of the R-CHOP study in the treatment of elderly patients with diffuse large B-cell lymphoma:: A study by the groupe d'Etude des lymphomes de l'adulte
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DOI：
10.1200/jco.2005.09.131
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发表时间：
2005-06-20
影响因子：
45.3
通讯作者：
Coiffier, B
中科院分区：
文献类型：
--
作者：
Feugier, P;Van Hoof, A;Coiffier, B
目的分析非霍奇金淋巴瘤研究98-5（LNH 98 -5）对老年弥漫性大B细胞淋巴瘤患者的长期预后，比较环磷酰胺、阿霉素、长春新碱和泼尼松（CHOP）与利妥昔单抗加CHOP（R-CHOP）的疗效。弥漫性大B细胞淋巴瘤患者接受8个周期的经典CHOP（环磷酰胺750 mg/m2，阿霉素50 mg/m2，长春新碱1.4 mg/m2，泼尼松40 mg/m2，共5天），每3周1次。在R-CHOP中，利妥昔单抗375 mg/m2与CHOP在同一天给药。结果目前中位随访时间为5年，无事件生存率、无进展生存率、无疾病生存率和总生存率均显著高于R-CHOP联合治疗组（P = 0.00002，P <0.00001，P <0.00031，P <0.0073，log-rank检验）。根据年龄调整的国际预后指数，低风险或高风险淋巴瘤患者如果接受联合治疗，生存期更长。结论采用R-CHOP联合方案治疗老年弥漫性大B细胞淋巴瘤可明显改善患者的预后，并可维持5年的随访。这种组合应该成为治疗这些患者的标准。
Purpose To analyze the long-term outcome of patients included in the Lymphome Non Hodgkinien study 98-5 (LNH98-5) comparing cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) to rituximab plus CHOP (R-CHOP) in elderly patients with diffuse large B-cell lymphoma.Patients and Methods LNH98-5 was a randomized study that included 399 previously untreated patients, age 60 to 80 years, with diffuse large B-cell lymphoma. Patients received eight cycles of classical CHOP (cyclophosphamide 750 mg/m(2), doxorubicin 50 mg/m(2), vincristine 1.4 mg/m(2), and prednisone 40 mg/m(2) for 5 days) every 3 weeks. In R-CHOP, rituximab 375 mg/m(2) was administered the same day as CHOP. Survivals were analyzed using the intent-to-treat principle.Results Median follow-up is 5 years at present, Event-free survival, progression-free survival, disease-free survival, and overall survival remain statistically significant in favor of the combination of R-CHOP (P = .00002, P < .00001, P < .00031, and P < .0073, respectively, in the log-rank test). Patients with low-risk or high-risk lymphoma according to the age-adjusted International Prognostic Index have longer survivals if treated with the combination. No long-term toxicity appeared to be associated with the B-CHOP combination.Conclusion Using the combination of R-CHOP leads to significant improvement of the outcome of elderly patients with diffuse large B-cell lymphoma, with significant survival benefit maintained during a 5-year follow-up. This combination should become the standard for treating these patients.