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目的 :进一步提高对 CHOP为主方案治疗中高度恶性非霍奇金淋巴瘤 ( NHL )疗效的认识。方法 :用国际预后指数 ( IPI)对 31例以 CHOP为主方案治疗的中高度恶性 NHL 患者的疗效进行评价。根据 IPI将患者分为低危和高危两大组 ,比较两组患者的生存状况。结果 :低危和高危组完全缓解患者分别为 16 /2 1例 ( 76 % )和 3/10例 ( 30 % ) ,部分缓解分别为 3/2 1例 ( 14 % )和 4/10例 ( 4 0 % ) ,复发 /进展分别为 2 /2 1例 ( 10 % )和 3/10例 ( 30 % )。中位生存期分别为 84( 3～ 132 )月和 6 .5 ( 0 .75～ 5 2 )月 ,两组差异显著 ( P=0 .0 0 32 )。 1.5年总生存率 ( OS)分别为 75 .89%和 2 0 % ,低危组 5年 OS为 5 9.15 % ,10年 OS为 33.83%。结论 :CHOP为主的第一代化疗方案对于不同危险程度的进展性 NHL 患者疗效明显不同。CHOP对于低危患者仍可作为首选和标准方案 ,对于高危患者可以考虑更强的或实验性的化疗方案
Objective: To further improve the understanding of the efficacy of CHOP-based regimen in the treatment of high-grade malignant non-Hodgkin’s lymphoma (NHL). METHODS: The efficacy of 31 intermediate-highly malignant NHL patients treated with CHOP was evaluated using the International Prognostic Index (IPI). According to the IPI, the patients were divided into low risk group and high risk group. The survival status of the two groups was compared. RESULTS: In the low-risk and high-risk groups, 16/21 (76%) and 3/10 (30%) patients had complete remission, partial remission was 3/2 1 (14%), and 4/10 patients ( 40%), recurrences/progressions were 2/21 (10 %) and 3/10 (30 %), respectively. The median survival time was 84 (3-132) months and 6.5 (0.755-52) months, respectively, with significant differences between the two groups (P=0.0 0 32). The 1.5-year overall survival (OS) was 75.89% and 20%, respectively. The low-risk group had a 5-year OS of 5.91% and a 10-year OS of 33.83%. Conclusion: The first-generation chemotherapy regimen based on CHOP is significantly different for patients with progressive NHL at different risk levels. CHOP is still the first choice and standard protocol for low-risk patients, and stronger or experimental chemotherapy can be considered for high-risk patients.