Objective: To compare the clinical outcome of cyclophosphamide, doxorubicin, vincristine, and prednisone ( CHOP ) to rituximab plus CHOP ( R - CHOP ) in adult patients with diffuse large - B - cell lymphoma. Methods: Previously untreated patients with diffuse large - B - cell lymphoma were assigned according to the Patients'intention to receive either six cycles of CHOP every three weeks or six cycles of CHOP plus rituximab chemotherapy regimen. Results: The rate of complete response was higher in the group that received CHOP plus rituximab than in the group that received CHOP alone ( 82.6％ VS 65.4％ , P = 0. 173 ), but no statistical difference was found between the groups. With a median follow - up of 35 months, the 3 - year overall survival rate and disease - free rate were significantly higher in the CHOP - plus - rituximab group ( P = 0.043 and P = 0. 029, respectively ). Clinically relevant toxicity was not significantly greater in group of CHOP plus rituximab. Conclusion: The combination of rituximab to the CHOP regimen significantly prolongs disease - free and overall survival in adult patients with diffuse large - B -cell lymphoma,without a clinically significant increase in toxicity.%目的:比较利妥昔单抗(商品名:美罗华)联合CHOP(环磷酰胺,阿霉素,长春新碱和泼尼松)与单用CHOP方案化疗治疗弥漫大B细胞淋巴瘤(diffuse large B cell lymphoma,DLBCL)的临床疗效.方法:根据患者的意愿,49例DLBCL患者分别接受6疗程CHOP方案或CHOP加利妥昔单抗方案化疗,每3周1疗程,共6个疗程.结果:R-CHOP组的CR率高于CHOP 组,但差异无统计学意义(82.6% VS 65.4%,P=0.173).中位随访时间为35月(4-66月),R-CHOP 组及CHOP组的3年OS分别为 75.0%±19.6%,54.9%±20.4%,P= 0.043;而3年EFS分别为69.7%±20.9%,45.8%±20.6%,P=0.029.R-CHOP组的3年OS及EFS 优于CHOP组,差异有统计学意义.两组患者的不良反应无明显差别.结论:与单用CHOP方案相比,利妥昔单抗联合CHOP方案明显提高DLBCL患者的EFS及OS,而不良反应无明显增加.
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