不适合移植的大 B 细胞淋巴瘤二线使用 axicabtagene ciloleucel:ALYCANTE 最终分析
Second-line axicabtagene ciloleucel in large B-cell lymphoma ineligible for transplantation: ALYCANTE final analysis.
CELL INTELLIGENCE · 肿瘤细胞治疗研究
肿瘤细胞治疗研究
英文原题:First-line LVDP (L-asparaginase, etoposide, dexamethasone, and cisplatin) regimen combined with radiotherapy is effective for early-stage extranodal natural killer/T-cell lymphoma, nasal type.
First-line LVDP (L-asparaginase, etoposide, dexamethasone, and cisplatin) regimen combined with radiotherapy is effective for early-stage extranodal natural killer/T-cell lymphoma, nasal type.
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化疗联合放疗可降低早期结外NK/T细胞淋巴瘤(ENKTL)的复发风险。然而,最佳联合化疗方案仍不明确。我们前期研究报道,LVDP(L-门冬酰胺酶、依托泊苷、地塞米松和顺铂)联合放疗是治疗早期ENKTL的一种潜在有效且安全的方案。
本研究通过更多患者和更长随访,进一步验证LVDP化疗联合放疗治疗早期ENKTL的疗效和安全性。我们回顾性研究了2010年9月至2019年9月期间的112例早期ENKTL患者。所有患者均接受LVDP方案,其中101例接受放疗。分析了患者的特征、治疗反应、生存结局、预后因素和毒性。中位随访时间为60个月(范围,4至117)。所有患者接受中位4个周期的LVDP化疗。治疗结束时,客观缓解率和完全缓解率分别为88.3%和77.6%。3年和5年OS分别为79.6%和73.2%,3年和5年PFS分别为75.4%和71.6%。其中,LVDP方案联合放疗产生了更有利的治疗结局(3年OS和PFS分别为83.1%和80.8%)。最常见的严重血液学毒性为白细胞减少(25%为3/4级),最常见的严重非血液学毒性为转氨酶升高(4.5%为3/4级)。未发生胰腺炎或治疗相关死亡。LVDP方案联合放疗对早期ENKTL患者具有良好的治疗反应和长期生存,且毒性可耐受。
Chemotherapy combined with radiotherapy could reduce the risk of recurrence in early-stage extranodal NK/T lymphoma (ENKTL).
However, the optimal combined chemotherapy regimen is still unknown.
Our previous study reported that LVDP (L-asparaginase, etoposide, dexamethasone, and cisplatin) combined with radiotherapy was a potentially effective and safe treatment regimen for early-stage ENKTL.
This study further validated the efficacy and safety of LVDP chemotherapy combined with radiation for early-stage ENKTL with more patients and longer follow-up.
We retrospectively studied 112 patients with early-stage ENKTL from September 2010 to September 2019. All patients received the LVDP regimen, and 101 of them received radiotherapy. The patients' characteristics, treatment responses, survival outcomes, prognostic factors, and toxicities were analyzed. The median follow-up was 60 months (range, 4 to 117). All patients received median 4 cycles of the LVDP chemotherapy. At the end of therapy, the objective response rate and complete response rate were 88. 3% and 77. 6%, respectively. The 3- and 5-year OS were 79. 6% and 73.
2%, and the 3- and 5-year PFS were 75. 4% and 71. 6%, respectively. Among them, the LVDP regimen combined with radiotherapy yielded more favorable treatment outcomes (the 3-year OS and PFS were 83. 1% and 80. 8%). The most common severe hematologic toxicity was leukopenia (25% grade 3/4), and the most common severe non-hematologic toxicity was increased transaminase (4.
5% grade 3/4). No pancreatitis or treatment-related death occurred. The LVDP regimen combined with radiotherapy had a good therapeutic response and long-term survival with tolerable toxicity for patients with early-stage ENKTL.
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