内容紹介
Summary
Background: Comorbidities among cancer patients are becoming more common. Comorbidity and relative dose intensity(RDI)are 2 major host-dependent prognostic factors for diffuse large B-cell lymphoma(DLBCL), but the clinical evidence demonstrating a relationship between those 2 factors is limited. Methods: We retrospectively analyzed the clinical records of patients with de novo DLBCL treated with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone(R-CHOP)therapy at the Okitama Public General Hospital between January 2010 and October 2018 to evaluate the relationship between comorbidity and RDI. Results: A total of 104 patients with a median age of 73 years(range, 36-90 years)were included. More than half of the patients(n=58, 55.8%)had at least one comorbidity. 3-year progression-free survival(p=0.043)and 3-year overall survival(p=0.049)were lower in the comorbidity group than in the no comorbidity group. The RDI was also lower in the comorbidity group than in the no comorbidity group(p=0.011). Univariate analysis of various factors influencing the RDI revealed that the presence of comorbidity was associated with insufficient RDI(p=0.016), but multivariate analysis revealed that only age >_75(p<0.001)was independently associated with insufficient RDI. Conclusions: Our results demonstrated that the presence of comorbidity was associated with insufficient RDI and poor treatment outcome in DLBCL patients treated with R-CHOP. To optimize the RDI maintenance to achieve better outcomes for DLBCL patients, further investigation of comorbidities is required.
要旨
がん患者に併存疾患を認めることが多くなっている。びまん性大細胞型B細胞リンパ腫(DLBCL)患者において併存疾患と相対治療強度は予後に影響するが,これら二つの要因の関連は明らかでない。今回われわれは,初発DLBCLに対してR-CHOP療法を行った104例を対象に後方視的に解析した。58例(55.8%)に併存疾患を認め,併存疾患群は非併存疾患群と比較して3年無増悪生存率(p=0.043)と3年生存率(p=0.049)が有意に低下し,相対治療強度も有意に減弱していた(p=0.011)。相対治療強度に影響する因子の単変量解析では,併存疾患は相対治療強度の減弱と関連した(p=0.016)。併存疾患は相対治療強度の減弱と関連し,生命予後に影響を与えると考えた。
目次
Background: Comorbidities among cancer patients are becoming more common. Comorbidity and relative dose intensity(RDI)are 2 major host-dependent prognostic factors for diffuse large B-cell lymphoma(DLBCL), but the clinical evidence demonstrating a relationship between those 2 factors is limited. Methods: We retrospectively analyzed the clinical records of patients with de novo DLBCL treated with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone(R-CHOP)therapy at the Okitama Public General Hospital between January 2010 and October 2018 to evaluate the relationship between comorbidity and RDI. Results: A total of 104 patients with a median age of 73 years(range, 36-90 years)were included. More than half of the patients(n=58, 55.8%)had at least one comorbidity. 3-year progression-free survival(p=0.043)and 3-year overall survival(p=0.049)were lower in the comorbidity group than in the no comorbidity group. The RDI was also lower in the comorbidity group than in the no comorbidity group(p=0.011). Univariate analysis of various factors influencing the RDI revealed that the presence of comorbidity was associated with insufficient RDI(p=0.016), but multivariate analysis revealed that only age >_75(p<0.001)was independently associated with insufficient RDI. Conclusions: Our results demonstrated that the presence of comorbidity was associated with insufficient RDI and poor treatment outcome in DLBCL patients treated with R-CHOP. To optimize the RDI maintenance to achieve better outcomes for DLBCL patients, further investigation of comorbidities is required.
要旨
がん患者に併存疾患を認めることが多くなっている。びまん性大細胞型B細胞リンパ腫(DLBCL)患者において併存疾患と相対治療強度は予後に影響するが,これら二つの要因の関連は明らかでない。今回われわれは,初発DLBCLに対してR-CHOP療法を行った104例を対象に後方視的に解析した。58例(55.8%)に併存疾患を認め,併存疾患群は非併存疾患群と比較して3年無増悪生存率(p=0.043)と3年生存率(p=0.049)が有意に低下し,相対治療強度も有意に減弱していた(p=0.011)。相対治療強度に影響する因子の単変量解析では,併存疾患は相対治療強度の減弱と関連した(p=0.016)。併存疾患は相対治療強度の減弱と関連し,生命予後に影響を与えると考えた。