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摘要
Objective: The purpose of this study was to clarify the long-term clinical outcome of elderly patients with localized aggressive lymphoma and to explore appropriate treatment strategies for this population.
Methods: Subjects of this multicenter prospective study were untreated patients aged >= 70 years with aggressive Stage IA-IIA lymphoma. Therapy with 80%-dose CHOP (cyclophosphamide 600 mg/m(2), doxorubicin 40 mg/m(2), vincristine 1.1 mg/m(2) and prednisolone 80 mg/day for 5 days) was repeated every 3 weeks. After three cycles of chemotherapy, involved-field radiotherapy was performed with 30-50 Gy in 15-28 fractions.
Results: A total of 24 patients (median age, 75 years; range, 70-84 years) were enrolled. Nineteen patients (79%) had non-bulky tumors,6 cm. The median follow-up period was 7.3 years. The 7-year overall and progression-free survival rates were 78.9% (95% confidence interval, 62.3-95.5) and 65.3% (95% confidence interval, 45.3-85.3), respectively. Six patients developed systemic relapse, two of them after 6 years. The median survival time after relapse was only 5 months (range, 2 weeks-5.2 years). Five patients developed second malignancies, and three other patients died from other causes without lymphoma progression. None of the patients developed local relapse within the radiation field and/or regional relapse in adjacent lymph node areas.
Conclusions: Although systemic relapses, short survival time after relapse and death from other causes occurred, no loco-regional relapses were observed. Less intensive radiotherapy such as low-dose and small field might not compromise the treatment outcome for this population.
- 出版日期2011-6
- 单位中国医学科学院肿瘤医院
