摘要
目的：评价应用CHOP与CHOP-L方案治疗血管免疫母细胞性T细胞淋巴瘤（AITL）的疗效及其预后影响因素。方法：对2005年1月-2012年1月经中国医科大学附属盛京医院病理及免疫组化结果确诊的45例AITL患者的临床资料及随访信息进行回顾性分析,分析CHOP与CHOP-L方案的治疗效果及其预后影响因素。结果：18例应用CHOP方案治疗,总有效率（OR）为50%,其中完全缓解率（CR）5例（27.8%）,部分缓解率（PR）4例（22.2%）;1、2、3年的总生存率（OS）分别为66.7%、44.4%及33.3%,无病生存率（DFS）分别为33.3%、22.2%、22.2%。27例应用CHOP-L方案化疗,OR为74%,其中CR 9例（33.3%）,PR 11例（40.7%）;1、2、3年的OS分别为81.4%、62.9%及37%,DFS分别为40.7%、33.3%、25.9%。应用CHOP-L方案化疗、Ann Arbor分期I-II期、结外侵犯0-1个、Ki-67≤50%、无巨大包块、无皮疹的患者疗效较好,且差异有统计学意义（P〈0.05）。Ann Arbor分期I-II期、ECOG评分0-1分、Ki-67≤50%、无巨大包块（〉10cm）、结外侵犯0-1个及应用CHOP-L方案化疗的患者均较对照组有较高的3年OS与DFS,且差异有统计学意义（P〈0.05）;女性患者及无B症状患者生存期优于男性及合并B症状患者（P〈0.05）,但DFS差异无统计学意义（P〉0.05）。多因素分析显示ECOG评分是影响本组患者生存的独立预后因素（P〈0.05）。结论：AITL以老年、晚期患者多见,预后较差,左旋门冬酰胺酶（L-ASP）联合CHOP方案化疗提高了其治疗的有效率、3年生存率及DFS,且安全性好,不良反应可耐受。Ann Arbor分期、结外侵犯、Ki-67≤50%、巨大包块、皮疹及化疗方案是影响近期疗效的重要因素。患者的Ann Arbor分期、ECOG评分、Ki-67、巨大包块、结外侵犯的程度及化疗方案的选择是影响预后的重要因素。
Objective：To investigate the treatment response and prognostic factors in patients with Angioimmuno-blastic T-cell lymphoma（AITL）treated by CHOP and CHOP-L chemotherapy.Methods：The clinical data of 45 pathology and immunohistochemistry cinfirmed patients with AITL in Shengjing Hospital Affiliated to China Medical University from January 2005 to January 2012 were retrospectively analyzed,in order to evaluate the treatment re-sponse and prognostic factors of CHOP and CHOP-L chemotherapy.Results：Of 18 cases treated by CHOP,overall response（OS）rate was 50%,complete remission（CR）rate was 27.8%（5/18）and parial remission（PR）rate was 22.2%（4/18）.The overall survival rates of 1,2 and 3 years were 66.7%,44.4%and 33.3%respectively.The dis-ease free survival rates were 33.3%,22.2%and 22.2%respectively.Of 27 cases treated by CHOP-L,OR rate was 74%,CR rate was 33.3%（9/27）and PR rate was 40.7%（11/27）.The overall survival rates of 1,2 and 3 years were 81.4%,62.9%and 37%respectively.The disease free survival rates were 40.7%,33.3%and 25.9%respec-tively.Ann Arbor stage I-II,extranodal involvement of 0-1 ,the patients without huge mass and rash,Ki-67≤50%and the application of CHOP-L chemotherapy had a better recent curative effect （P〈0.05 ）.Ann Arbor stage I-II,ECOG scoring 0-1 ,extranodal involvement of 0-1 ,the patients without huge bulge,Ki-67≤50%and the appli-cation of CHOP-L chemotherapy had a higher 3-year overall survival rate and disease free survival rate compared with control group （P〈0.05 ）.Female patients and patients without B symptoms had a better overall survival rate compared with male patients and patients with B symptoms （P〈0.05 ）,but there was no statistical significance difference in DFS （P〉0.05 ）.Multi -factors analysis of ECOG scoring was independent prognostic factor in this group of patients （P〈0.05）.Conclusion：AITL is a kind of disease with poor prognosis.The use of L-asparaginase （L-ASP）improves the rate of response to chemothera
出处
《现代肿瘤医学》
CAS
2016年第19期3115-3120,共6页
Journal of Modern Oncology
