CAJ | 학술논문

目的比较利妥昔单抗联合CHOP方案(R-CHOP)和利妥昔单抗联合分割剂量的CHOP方案(R-fCHOP)治疗原发于胃的弥漫大B细胞淋巴瘤(PG-DLBCL)的疗效和安全性.方法回顾性收集2010年3月至2014年3月在复旦大学附属肿瘤医院治疗的50例PG-DLBCL患者的临床资料,比较接受R-CHOP和R-f CHOP方案的两组患者在治疗过程中消化道出血、穿孔的发生率及其对后续治疗的影响,同时比较两组患者的疗效.结果 40例患者接受了R-CHOP方案化疗,10例患者接受了R-f CHOP方案化疗.接受R-fCHOP方案化疗的患者Lugano分期较晚,胃溃疡的大小和深度均较大.接受R-f CHOP方案化疗的患者中,有1例(10.0％)出现大便隐血阳性;接受R-CHOP方案化疗的患者中,有11例(31.4％)出现大便隐血阳性,其中1例患者因呕血停止了后续化疗.两组患者化疗后均未出现穿孔.接受R-CHOP方案和R-f CHOP方案化疗患者的有效率分别为92.5％和90.0％,差异无统计学意义(P＞0.05).两组患者的无进展生存曲线的差异无统计学意义(P＞0.05).结论 R-f CHOP方案在Lugano分期晚,溃疡较深、较大的高出血穿孔风险PG-DLBCL患者中有较好的安全性,其近期疗效与R-CHOP方案相似.
목적 비교리타석단항연합CHOP방안(R-CHOP)화리타석단항연합분할제량적CHOP방안(R-fCHOP)치료원발우위적미만대B세포림파류(PG-DLBCL)적료효화안전성.방법 회고성수집2010년3월지2014년3월재복단대학부속종류의원치료적50례PG-DLBCL환자적림상자료,비교접수R-CHOP화R-f CHOP방안적량조환자재치료과정중소화도출혈、천공적발생솔급기대후속치료적영향,동시비교량조환자적료효.결과 40례환자접수료R-CHOP방안화료,10례환자접수료R-f CHOP방안화료.접수R-fCHOP방안화료적환자Lugano분기교만,위궤양적대소화심도균교대.접수R-f CHOP방안화료적환자중,유1례(10.0％)출현대편은혈양성;접수R-CHOP방안화료적환자중,유11례(31.4％)출현대편은혈양성,기중1례환자인구혈정지료후속화료.량조환자화료후균미출현천공.접수R-CHOP방안화R-f CHOP방안화료환자적유효솔분별위92.5％화90.0％,차이무통계학의의(P＞0.05).량조환자적무진전생존곡선적차이무통계학의의(P＞0.05).결론 R-f CHOP방안재Lugano분기만,궤양교심、교대적고출혈천공풍험PG-DLBCL환자중유교호적안전성,기근기료효여R-CHOP방안상사.
Objective The aim of this study was to compare the safety and efficacy profiles of RCHOP and R-fCHOP regimes in the treatment of primary gastric diffuse large B cell lymphoma (PGDLBCL).Methods Data of PG-DLBCL patients admitted in our hospital from March 2010 to March 2014 were collected retrospectively.Differences in gastrointestinal bleeding and perforation between the R-CHOP group and R-fCHOP group were compared.The influence of the gastrointestinal complication on subsequent treatment was also analyzed.Treatment outcome of the two groups was also compared.Results A total of 50 patients were included in this retrospective study.Forty of them were in the R-CHOP group,another ten were in the R-fCHOP group.Patients in the R-fCHOP group had a higher rate of Lugano late stage disease,and a relatively high rate of a deeper/larger ulcer.Fence occult blood test (FOBT) was positive in one (10.0％) patient in the R-fCHOP group,and 11 (31.4％) patients in the R-CHOP group,among them one had hematemesis and had to give up the subsequent chemotherapy.No perforation was observed in both groups.The response rate (RR) was 92.5％ in the R-CHOP group and 90.0％ in the R-fCHOP group (P ＞0.05).The PFS was also comparable between the two groups (P ＞0.05).Conclusions R-fCHOP regimen has a good safety profile in patients with Lugano late stage and deep/large ulcers,who are of high risk of gastrointestinal bleeding or perforation,and also has a comparable efficacy profile when compared with the RCHOP regimen in short-term follow-up.