放化疗与单纯化疗对原发纵隔大B细胞淋巴瘤患者生存的影响比较

范冰杰; 常宇; 柳喜洋; 张明智; 张蕾

doi:10.3971/j.issn.1000-8578.2022.21.0716

放化疗与单纯化疗对原发纵隔大B细胞淋巴瘤患者生存的影响比较

Effects of Chemoradiotherapy Versus Chemotherapy Alone on Survival of Patients with Primary Mediastinal Large B-cell Lymphoma

摘要

摘要:
目的探讨原发纵隔大B细胞淋巴瘤（PMBCL）的预后影响因素，分析利妥昔单抗时代前后接受放化疗与单纯化疗对患者预后的影响。
方法从SEER数据库中提取2001—2015年间确诊的PMBCL患者, SEER Stat软件计算PMBCL的发病率，Kaplan-Meier法和Cox回归模型分析各临床变量对预后的影响。
结果排除信息不完整的患者外，共纳入635例PMBCL患者。多因素Cox回归分析结果显示，年龄、分期、化疗是OS和DSS的独立预后因素。Kaplan-Meier生存分析显示，2006—2015年接受单纯化疗患者的OS明显优于2001—2005年的患者（χ²=10.002, P=0.002）。2001—2005年接受化疗联合放疗患者的OS优于接受单纯化疗的患者，两组患者的DSS未见明显差异。2006—2015年接受放化疗联合治疗患者的OS和DSS与接受单纯化疗患者无明显差异。
结论利妥昔单抗的应用改善了原发纵隔大B细胞淋巴瘤患者的长期生存，2006—2015年中接受放化疗的患者与接受单纯化疗的患者预后相当。

Abstract:
Objective To explore the prognostic factors of primary mediastinal large B-cell lymphoma (PMBCL) and the effects of chemoradiotherapy versus chemotherapy alone on patients' prognosis before and after rituximab era.
Methods We extracted the data of PMBCL patients diagnosed from 2001 to 2015 from SEER database. SEER Stat software was used to calculate the incidence rate. Kaplan-Meier method and Cox regression model were used to analyze the impact of various clinical variables on prognosis.
Results We included 635 patients with PMBCL. Multivariate Cox regression analysis showed that age, stage and chemotherapy were independent prognostic factors. Kaplan-Meier survival analysis showed that OS of the patients receiving chemotherapy only in 2006-2015 was significantly better than that in 2001-2005 (χ²=10.002, P=0.002). The patients who received chemoradiotherapy had better OS than those who received chemotherapy alone from 2001 to 2005. The OS and DSS of patients receiving chemoradiotherapy were not significantly different from those of chemotherapy alone from 2006 to 2015.
Conclusion The application of rituximab improves the long-term survival of PMBCL patients. The prognosis of patients who received chemoradiotherapy is comparable to that of chemotherapy alone from 2006 to 2015.

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