Impact of immunochemotherapy regimens on outcomes of patients with primary mediastinal B-cell lymphoma in the IELSG37 trial.

This report evaluates outcomes after different frontline rituximab- and doxorubicin-based immunochemotherapy regimens chosen according to local practice.

本报告评估了根据当地实践选择的不同前线利妥昔单抗和多柔比星为基础的免疫化疗方案的治疗结果。

Patients treated with R-CHOP21 (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisolone, administered every 21 days) showed a significantly higher percentage of DS 5 than those on other regimens (23.8% vs 8.2% average; P < .001) and a trend toward additional unplanned treatments (53.2% vs 46.9%; P = .30).

接受R-CHOP21（利妥昔单抗、环磷酰胺、多柔比星、长春新碱、泼尼松，每21天一次）治疗的患者显示出比其他方案更高的完全缓解（CR）百分比（23.8% vs 8.2%平均；P < .001），并且有额外未计划治疗的趋势（53.2% vs 46.9%；P = .30）。

The increased risk of poor response was confirmed in a multinomial logistic regression analysis adjusted for age, sex, international prognostic index score, and performance status.

在调整年龄、性别、国际预后指数评分和体能状态的多项逻辑回归分析中，证实了对不良反应风险的增加。

R-CHOP21 was also associated with smaller reductions in metabolic tumor volume and less pronounced decreases in maximum standardized uptake value.

R-CHOP21也与代谢肿瘤体积减少较小和最大标准化摄取值下降不明显有关。

Patients with DS 5 more often received additional treatment (RT and/or salvage chemotherapy with or without autologous consolidation) after induction immunochemotherapy (96% vs 41%; P < .001) and experienced significantly poorer outcomes.

在诱导免疫化疗后，DS 5的患者更常接受额外治疗（放疗和/或挽救性化疗，有或无自体巩固治疗）（96%对比41%；P<.001），并且经历了显著较差的结果。

Although differences in progression-free and overall survivalbetween R-CHOP21 and more aggressive regimens were not statistically significant, R-CHOP21 may increase the risk of additional treatments and may be inadvisable as frontline therapy for PMBCL.

尽管R-CHOP21与更积极治疗方案在无进展生存（progression-free survival）和总生存（overall survival）方面的差异在统计学上不显著，但R-CHOP21可能会增加额外治疗的风险，可能不建议作为原发性纵隔大B细胞淋巴瘤（primary mediastinal B-cell lymphoma, PMBCL）的一线治疗。

This trial was registered at www.clinicaltrials.gov as #NCT01599559.

该试验已在www.clinicaltrials.gov上注册，注册号为#NCT01599559。