R-CHOP与CHOEP方案治疗弥漫大B细胞淋巴瘤临床对比研究

摘要

Objective:To compare the effect,progression-free survival(PFS) and overall survival(OS) of rituximab combined with cyclophosphamide,hydrochloride,vincristine,prednisone chemotherapy (R-CHOP) and CHOP combined with VP-16 regimen(CHOEP) on patients with diffuse large B-cell lymphoma.Methods:A total of 73 patients with diffuse large B-cell lymphoma(DLBCL) were non-randomly divided into two groups:39patients were treated with R-CHOP regimen for 4-6 cycles,the others treated with CHOEP regimen for 4-6 cycles.Results:In R-CHOP groups,14 complete response(CR) and 12 partial response (PR) were observed,the total response rate (CR + PR) was 71.8 ％ (28/39).In CHOEP groups,12 complete response (CR) and 11 partial response(PR) were observed,the total response rate (CR + PR) was 67.6％ (23/34).The rate of CR + PR was higher in R-CHOP group than that in CHOP + E group(71.8％ vs 67.6％),but no statistical difference was found between the two groups(P ＞0.05).Minewhile we found that the clinical stage,LDH levels,origin of B-cell(GCB or Non-GCB)and bulky disease could affect the therapeutic effect with univariate analysis(P ＜0.05).A median follow-up of 28-mouth of PFS and OS:R-CHOP group were (54.8 ± 5.2) ％ and (65.4 ± 5.7) ％,CHOEP group were (47.6 ± 4.5) ％ and (53.3 ± 4.9) ％,respectively.There were significant differences between PFS and OS in the two groups (P ＜ 0.05).Conclusion:The combination of rituximab to the CHOP regimen significantly prolongs PFS and OS in patients with diffuse large B-cell lymphoma without significant increase of toxicity.%目的:探讨R-CHOP与CHOEP两种方案治疗弥漫大B细胞淋巴瘤(DLBCL)的疗效,比较无进展生存期(PFS)和总生存期(OS).方法:采用同期(2006-01～2012-06)非随机对照的方法,将73例DLBCL患者分为2组,39例患者接受R-CHOP方案治疗4～6疗程,34例患者接受CHOEP方案4～6疗程.结果:R-CHOP组39例患者中16例获完全缓解(CR),12例获部分缓解(PR),总有效率(CR+ PR)为71.8％ (28/39)；CHOEP组34例,CR 12例,PR 11例,总有效率(CR+ PR) 67.6％(23/34)；R-CHOP组CR+ PR率高于CHOEP组,但差异无统计学意义(P＞0.05).单因素分析发现,CR及PR率与临床分期、LDH水平、B细胞来源(GCB型,Non-GCB型)及有无大包块病变有关(均P＜0.05).中位随访时间28个月,R-CHOP方案治疗后患者28个月的PFS和OS分别为(54.8±5.2)％和(65.4±5.7)％；CHOEP组分别为(47.6±4.5)％和(53.3±4.9)％；两组PFS和OS比较差异有统计学意义(P＜0.05).结论:与CHOEP方案相比,利妥昔单抗联合CHOP方案能够提高弥漫大B细胞淋巴瘤患者的无进展生存期及总生存期,而不良反应未见增加.