1. [Rituximab-Based Regimens for Treatment of Primary Gastric Diffuse Large B-Cell Lymphoma]
- Author
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Shuang, Qu, Li-Sheng, Liao, Zhi-Hai, Zheng, Ying, Xie, Wei-Min, Chen, and Bi-Yun, Chen
- Subjects
Adult ,Male ,L-Lactate Dehydrogenase ,Middle Aged ,Prognosis ,Disease-Free Survival ,Doxorubicin ,Vincristine ,Antineoplastic Combined Chemotherapy Protocols ,Humans ,Prednisone ,Female ,Lymphoma, Large B-Cell, Diffuse ,Rituximab ,Cyclophosphamide ,Aged ,Retrospective Studies - Abstract
To analyze clinical response of the Rituximab-based chemotherapy and prognostic features in patients with primary gastric diffuse large B-cell lymphoma (PGDLBCL).From June 2008 to December 2020, the data of 53 PGDLBCL patients were analyzed retrospectively.The median age was 46(25-77) years old in 53 patients including 35 males and 18 females. Stomachache is the most common symptom. The diagnosis were confirmed in 47 patients by endoscopic biopsy and 6 patients by surgery. Twenty-six patients had Ⅰ/Ⅱ1 stage (Lugano staging system) disease and 27 cases had II2/IV stage disease. All patients were treated with chemotherapy, including RCHOP (25/53) and R-DA-EPOCH (28/53). Complete remission rate was 79.2%(42/53). The 3-year and 5-year overall survival (OS) rates were 77.4% and 69.8%. Univariate analysis showed that lactate dehydrogenase(LDH), Lugano stage and lesion size affected OS. Multivariate Cox regression analysis revealed that IPI score and Lugano stage were independent prognosis risk factors affecting OS. The patients in the R-DA-EPOCH group presented better survival outcomes than those in the RCHOP group with late stage (PRituximab in combination with chemotherapy is the backbone of therapy for PGDLBCL. IPI score and Lugano stage are independent prognosis risk factors affecting OS of PGDLBCL. R-DA-EPOCH can be superior to R-CHOP as a first-line regimen in PGDLBCL patients with late stage.含利妥昔单抗方案治疗原发胃弥漫大B细胞淋巴瘤疗效分析.探讨含利妥昔单抗方案治疗原发胃弥漫大B细胞淋巴瘤(PGDLBCL)的临床疗效及预后影响因素.回顾性分析福建省立医院2008年6月-2020年12月收治并接受正规治疗的53例PGDLBCL患者的临床资料,患者均接受利妥昔单抗为基础的诱导化疗,评估疗效,观察临床特征、生物学指标对总生存(OS)和无进展生存(PFS)的影响.53例患者中男性35例,女性18例,中位年龄46(25-77)岁,以腹痛为主要临床表现,胃镜活检确诊47例,手术诊断为6例。Lugano分期Ⅰ/Ⅱ1期26 例,II2/IV期27例。25例患者接受RCHOP方案诱导化疗,28例接受R-DA-EPOCH 方案诱导化疗。42例达完全缓解,3和5年OS率分别为77.4%、69.8%。单因素分析结果显示,乳酸脱氢酶、IPI评分、Lugano分期、病变大小影响PGDLBCL患者的OS;多因素分析结果显示,IPI评分高及Lugano分期晚者预后差。晚期患者R-DA-EPOCH方案的5年OS明显优于RCHOP方案(P=0.035).含利妥昔单抗的免疫化疗是治疗PGDLBCL的基石,IPI评分及Lugano分期是影响PGDLBCL患者总生存的独立危险因素。对于晚期预后不良患者,R-DA-EPOCH方案较RCHOP方案更易生存获益.
- Published
- 2022