外周T细胞淋巴瘤的治疗和生存预后分析

Treatment and survival prognosis analysis of peripheral T-cell lymphoma

目的分析外周T细胞淋巴瘤(PTCL)的临床特征、生存和预后影响因素。方法回顾性分析253例PTCL患者的临床特征、生存和预后影响因素等资料。采用Kaplan-Meier法进行生存分析,log-rank检验进行组间比较,Cox比例风险回归模型进行单因素及多因素分析。结果253例患者中位年龄为60岁,3、5、10 a的疾病无进展生存(PFS)率分别为43.70%、36.60%和20.60%,3、5和、10 a的总生存(OS)率分别为56.60%、49.20%和30.00%。多因素Cox分析结果回示,Ann Arbor分期(HR=3.600,95%CI=1.277~10.145,P=0.015)是PFS独立的不良预后因素,Ann Arbor分期(HR=4.812,95%CI=1.389~16.679,P=0.013)和国际预后指数评分(HR=0.308,95%CI=0.109~0.870,P=0.026)是OS独立的不良预后因素。GDPT方案组患者的总反应率、PFS率和OS率明显高于CHOP方案组(P=0.033、0.011、0.042)。结论Ann Arbor分期和IPI评分是影响PFS和OS的预后因素,GDPT是一种具有前景的新方案,有望成为PTCL的一线疗法。

Objective To analyze the clinicopathological features,survival outcomes and prognostic factors of peripheral T-cell lymphoma(PTCL).Methods Clinicopathological features,survival outcomes and prognostic factors of PTCL were retrospectively analyzed in 253 patients.Survival analysis was performed by Kaplan-Meier method,and differences between the study groups were compared by the log-rank test.The clinical and laboratory indicators were estimated with univariate and multivariate analyses by Cox proportional hazard model.Results The median age of the 253 patients was 60 years old,the 3-year,5-year and 10-year progression free survival(PFS)rates were 43.70%,36.60%and 20.60%,respectively,the 3-year,5-year and 10-year overall survival(OS)rates were 56.60%,49.20%and 30.00%,respectively.By multivariate Cox regression analysis,independent unfavorable prognostic factors for PFS was Ann Arbor stage(HR=3.600,95%CI=1.277-10.145,P=0.015),and independent unfavorable prognostic factors for OS were Ann Arbor stage(HR=4.812,95%CI=1.389-16.679,P=0.013)and international prognostic index score(HR=0.308,95%CI=0.109-0.870,P=0.026).In the GDPT regimen group,the overall response rate,the rates of PFS and OS were significantly higher than the CHOP regimen group(P=0.033,0.011,0.042).Conclusion Ann Arbor stage and IPI score were prognostic factors for PFS and OS.The GDPT is a promising new regimen and may become the first-line therapy for PTCL.