RCHOP方案治疗成人睾丸弥漫性大B细胞淋巴瘤的临床疗效分析——附31例报告

The therapeutic efficacy of rchop chemotherapy regimen for adult testicular diffuse large b cell lymphoma:a report of 31 cases

目的:探讨RCHOP方案治疗成人睾丸弥漫性大B细胞淋巴瘤(DLBCL)的临床疗效。方法:31例成人睾丸DLBCL在睾丸癌根治性切除术后均接受RCHOP方案辅助性化学治疗,初治性化学治疗失败后改用其他挽救性化学治疗或放射治疗并定期随访,观察初治性化学治疗疗效、患者生存时间及治疗期间出现的不良反应。结果:31例均完成化学治疗。随访10～96个月,5例Ⅰ_E期患者均无瘤生存;其余26例可评价疗效,初治性化学治疗总有效率为73%(19/26),其中完全缓解率为39%(10/26),部分缓解率为35%(9/26)。31例患者中,17例(55%)死亡,中位生存期为28个月,1年、3年和5年的生存率分别为94%,55%和41%。Ⅰ_E期、Ⅱ_E期、Ⅲ_E期、Ⅳ期肿瘤总体生存率分别为100%、57%、40%、0,不同病理分期成人睾丸DLBCL患者的总生存率比较差异有统计学意义(P<0.01)。化学治疗过程中出现不良反应主要为不同程度的骨髓抑制、消化道反应,经对症处理后症状缓解。结论:RCHOP方案初治性化学治疗成人睾丸DLBCL效果良好,不良反应较轻,患者耐受性好。

Objective： To investigate the therapeutic effects of RCHOP chemotherapy regimen for patients with diffused large B cell cancer. Methods： Thirty-one patients with DLBCL were received adjuvant chemotherapy with RCHOP regimen after initial surgery. Radiotherapy or other salvage chemotherapy regimen was given in case of first-line chemotherapy failure. Rigorous follow-ups were conducted semiannually for all patients. Results： All 31 cases were finished the treatment of adjuvant chemotherapy with RCHOP. Follow-up time ranged from 10 to 10 to 96 months. All 5 stage I E patients survived without tumor recurrence or progression. The therapeutic outcomes of the other 26 patients were assessable. After first-line chemotherapy, the overall response rate was 73% （19/26）, with complete remission （CR） rate of 39% （10/26） and partial response rate （PR） of 35% （9/26）. Among the 31 patients, 17 （58%） cases died of DLBCL with a median survival time of 28 months. The 1-, 3- and 5-yr over- all survival rates were 94%, 55% and 41%, respectively. There were significant difference in survival rates of stage I E, ⅡE, ⅢE and Ⅳ （100%, 57%, 40% vs 0, P〈0.01）. Conclusion： Most patients with testicular DLBCL were sensitive to RCHOP chemotherapy with tolerated side effects.