摘要
目的明确美国国家综合癌症网络国际预后指数（NCCN—IPI）对外周T细胞淋巴瘤（PTCL）患者化疗后的预后评估价值。方法回顾性分析2003年1月至2013年5月接受CHOP或CHOP样方案化疗的162例初治PTCL患者的临床资料，采用国际预后指数（IPI）和NCCN—IPI进行危险分层和预后评估。结果①162例患者预期5年总生存（OS）和无进展生存（PFS）率分别为33％和20％，中位OS和PFS时间分别为17．0和9．2个月。②多因素分析提示美国东部肿瘤协作组体能状态评分（ECOG评分）≥2分（PFS：HR=2．418，95％CI1．535～3．809，P〈0．001；OS：HR=2．347，95％CI1．435—3．839，P=0．001）和存在特定的结外病变部位（PFS：HR=1．800，95％CI1．216～2．665，P=0．003；OS：HR=1．608，95％CI1．054～2．454，P=0．027）是影响患者PFS和OS的独立危险因素；ALK＋是影响间变性大细胞淋巴瘤患者PFS（HR=0．424，95％C10．184～0．975，P=0．043）及OS（HR=0．276，95％C10．087～0．877，P=0．029）的独立预后良好因素。③NCCN-IPI低危组患者的生存率显著高于IPI低危组患者（5年OS率74％对54％，χ2=5．041，P=0．025；5年PFS率50％对38％，χ2=5．295，P=0．021），差异均有统计学意义。结论NCCN-IPI较IPI对低危PTCL患者具有更好的预后判断意义，可作为PTCL患者有效的预后分层工具。
Objective To validate the prognostic value of NCCN-Intemational Prognostic Index （NCCN-IPI） for patients with peripheral T-cell lymphoma （PTCL） treated with CHOP-based chemotherapy. Methods A retrospective analysis in 162 PTCL patients who were initially diagnosed and treated in Rui Jin Hospital from January 2003 to May 2013 was conducted. Baseline characteristics were collected, and survival analysis was performed according to the IPI and NCCN-IPI model. Results The estimated 5-year overall survival （OS） rate and progression free survival （PFS） rate were 33% and 20%, with median OS and PFS of 17.0 months and 9.2 months, respectively. Multivariate analysis indicated ECOG score （PFS： HR = 2.418, 95%CI 1.535-3.809, P 〈 0.001; OS： HR = 2.347, 95%CI 1.435-3.839, P = 0.001 ）, specific extra-nodal sites （PFS： HR = 1.800, 95%CI 1.216-2.665, P = 0.003; OS： HR = 1.608, 95% CI 1.054-2.454, P= 0.027） and pathology type （PFS： HR = 0.424, 95%CI 0.184-0.975, P= 0.043; OS： HR = 0.276, 95%CI 0.087-0.877, P = 0.029） were independent prognostic factors of OS and PFS for the patients with PTCL. The survival rates of low risk patients based on NCCI-IPI were remarkably higher than the counterparts based on IPI （5-year OS 74% vs 54%, χ2 = 5.041, P = 0.025, 5-year PFS 50% vs 38%, χ2= 5.295, P = 0.021 ）. NCCN-IPI was outstanding to identify the subgroup of low risk patients with PTCL, who may benefit from conventional chemotherapy such as CHOP or CHOP-like regimen. Conclusion NCCN-IPI is more powerful for low risk PTCL patients and a strong supplement for IPI.
出处
《中华血液学杂志》
CAS
CSCD
北大核心
2017年第9期772-777,共6页
Chinese Journal of Hematology
关键词
淋巴瘤
T细胞
外周
预后
国际预后指数
美国国家综合癌症网络国际预后指数
Lymphoma, T-cell, peripheral
Prognosis
International prognostic index
Nationalcomprehensive cancer network international prognostic index
