CHOP versus MACOP-B in aggressive lymphoma--a Nordic Lymphoma Group randomised trial.
CHOP versus MACOP-B in aggressive lymphoma--a Nordic Lymphoma Group randomised trial.
复制标题
CHOP 与 MACOP-B 治疗侵袭性淋巴瘤——北欧淋巴瘤组随机试验。
DOI：
10.1023/a:1008392528248
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发表时间：
1999
期刊：
影响因子：
--
通讯作者：
M. Åkerman
中科院分区：
文献类型：
--
作者：
M. Jerkeman;H. Anderson;E. Cavallin;M. Dictor;H. Hagberg;A. Johnson;S. Kaasa;S. Kvaløy;C. Sundström;M. Åkerman
背景
在过去的二十年中，晚期侵袭性淋巴瘤患者的长期生存率没有显著提高。在一项随机试验中，将MACOP-B（一种每周6次的化疗方案）的疗效与CHOP（目前的标准方案）在总体和无失败生存期、毒性和健康相关生活质量方面进行了比较。
患者和方法
405例侵袭性淋巴瘤患者，II-IV期，年龄18-67岁，随机接受12周MACOP-B或8个疗程CHOP治疗24周。特别强调了结节病安阿伯期的定义。95名患者的子集也进入了基于EORTC QLQ-C30的生活质量研究。
结果
31例患者不合格。在其余374例患者中，中位年龄为52岁。根据年龄调整的国际预后指数，37%的患者为“高-中等”或“高风险”患者。无论是总生存率（MACOP-B组5年时为60%，CHOP组为59%）还是无失败生存率（MACOP-B组5年时为47%，CHOP组为44%）均无差异。在生活质量方面，接受MACOP-B的患者的身体功能和整体生活质量受损更严重，这些患者也表现出更多的非血液学毒性。
结论
未证明MACOP-B与CHOP相比具有优效性。CHOP仍然是低风险患者的治疗选择。目前，强化或实验性治疗应保留给高危疾病。
BACKGROUND
The long-term survival of patients with advanced stage aggressive lymphoma has not improved significantly during the last twenty years. In a randomised trial, the efficacy of MACOP-B, a six-drug weekly chemotherapy regimen, was compared to CHOP, the current standard regimen, in terms of overall and failure-free survival, toxicity and health related quality of life.
PATIENTS AND METHODS
Four hundred five patients with aggressive lymphoma, stage II-IV, age 18-67, were randomised to receive either 12 weeks of MACOP-B or 8 courses of CHOP over 24 weeks. Special emphasis was put in the definition of Ann Arbor stage in extranodal disease. A subset of 95 patients also entered a quality of life study, based on the EORTC QLQ-C30.
RESULTS
Thirty-one patients were ineligible. Among the remaining 374 patients, the median age was 52 years. According to the age-adjusted International Prognostic Index, 37% were 'high-intermediate' or 'high-risk' patients. No difference could be demonstrated, either in overall survival (60% at five years in the MACOP-B group and 59% in the CHOP group) or in failure-free survival (47% at five years with MACOP-B and 44% with CHOP). In terms of quality of life, physical function and global quality of life were more impaired in patients receiving MACOP-B, who also exhibited more non-haematological toxicity.
CONCLUSION
No superiority of MACOP-B compared to CHOP could be demonstrated. CHOP remains the treatment of choice in low-risk patients. At present, intensified or experimental treatment should be reserved for high-risk disease.
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影响因子：
11.2
作者：
P. Carbone;H. Kaplan;K. Musshoff;D. Smithers;M. Tubiana
通讯作者：
P. Carbone;H. Kaplan;K. Musshoff;D. Smithers;M. Tubiana
影响因子：
158.5
作者：
GORDON, LI;HARRINGTON, D;OCONNELL, M
通讯作者：
OCONNELL, M
影响因子：
45.3
作者：
KWAK, LW;HALPERN, J;HORNING, SJ
通讯作者：
HORNING, SJ
影响因子：
158.5
作者：
FISHER, RI;GAYNOR, ER;MILLER, TP
通讯作者：
MILLER, TP