摘要
目的分析初治原发性胃弥漫大B细胞淋巴瘤（primary gastric diffuse large B cell lymphoma,PGDLBCL）的临床特征、诊断、治疗和预后,探讨利妥昔单抗的作用。方法回顾性分析2005年1月至2012年5月军事医学科学院附属医院收治的26例初治PGDLBCL患者的临床特征、诊断、治疗、近期和远期疗效,以及不同治疗方法和预后因素与疗效的关系。结果纳入26例PGDLBCL患者,男性14例,女性12例,中位年龄50.1岁,最常见症状为腹痛。全组患者采用化疗联合放疗的综合治疗模式,分为单纯CHOP组（n=9）和RCHOP组（n=17）,CR率分别为55.56%（5/9）和50%（8/16）,两组差异无显著性意义。中位随访40个月（3～84个月）,全组5年无进展生存期为60.3%,总生存期74.4%。其中RCHOP组分别为58.9%和84.6%,CHOP组为66.7%和66.7%,RCHOP组优于CHOP组,但无统计学差异。单因素分析显示Lugano分期和IPI评分显著影响预后。结论化疗可作为PGDLBCL的一线治疗,加用利妥昔单抗可能有利于提高远期生存率;临床分期和IPI评分是重要预后因素。
Objective To analyze the clinical characteristics,diagnosis,therapy and prognosis of new diagnosed primary gastric diffuse large B cell lymphoma（PGDLBCL） and to discuss the efficacy of rituximab.Methods Between Jan2005 and May 2012,twenty-six new-diagnosed PGDLBCL patients were reviewed retrospectively.The clinical characteristics,diagnosis,therapy,results and prognostic factors were analyzed.Results There were 14 males and 12 females.Their age ranged from 25 to 82（median,50.1） years old.The most common symptom was stomachache.Treatment strategies were chemotherapy alone（n = 9） [scheduled as cyclophosphamide,doxorubicin,vincristine and prednisone（CHOP） and CHOP-like]and chemotherapy combined with rituximab（n = 17）,followed by radiotherapy of the stomach with or without regional nodes.All clinical and pathological features were similar between the two groups.The median follow-up time was40 months.The overall response rate was 100%（9/9） in CHOP group,including 55.56%（5/9） CR,and 93.75%（15/16） in RCHOP group including 50%（8/16） CR（P〈0.05）.The total PFS and OS of 5 years were 60.3% and 74.4%respectively.The PFS in CHOP group and RCHOP group was 66.7% and 58.9%,respectively,and the OS was 66.7%and 84.6%,respectively.Although the OS of RCHOP group was much better than that of CHOP group,there was no statistically significant difference.Univariate analysis showed that IPI（P〈0.05） and Lugano staging（P〈0.05） were independent factors of survival in patients with PGDLBCL.Conclusion Chemotherapy could be the first-line therapy of PGDLBCL.The overall survival rate might be increased by adding rituximab to chemotherapy.The Lugano stage and IPI are important prognostic factors.
出处
《军事医学》
CAS
CSCD
北大核心
2014年第7期542-546,共5页
Military Medical Sciences
