Optimally Delivered R-da-EPOCH Versus R-CHOP-21 in Primary Mediastinal Large B-Cell Lymphoma: A Real-Life Comparison in a Single Academic Center.

IF 4.5 2区医学 Q1 ONCOLOGY

Cancers Pub Date : 2025-05-19 DOI:10.3390/cancers17101699

Alexia Piperidou, Maria K Angelopoulou, Chrysovalantou Chatzidimitriou, John V Asimakopoulos, Maria Arapaki, Fotios Panitsas, Gerassimos Tsourouflis, Marina Belia, Iliana Konstantinou, Anastasia Kopsaftopoulou, Athanasios Liaskas, Alexandros Machairas, Maria-Aikaterini Lefaki, Maria Dimitrakoudi, Sotirios Sachanas, Gerassimos A Pangalis, Konstantinos Konstantopoulos, Eleni Plata, Marina Siakantaris, Theodoros P Vassilakopoulos

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引用次数: 0

Abstract

Background/objectives: The National Cancer Institute introduced the intensified R-da-EPOCH regimen in primary mediastinal large B-cell lymphoma (PMLBCL) to improve outcomes while minimizing radiotherapy use. However, there is no randomized comparison of R-da-EPOCH vs. R-CHOP-21. The objective of this study was to compare R-da-EPOCH with R-CHOP-21 in consecutive patients with PMLBCL of a single, large referral center, where the R-da-EPOCH escalation schedule was strictly followed.

Methods: We retrospectively analyzed all 35 consecutive patients who received R-da-EPOCH (2017-2022) compared to 35 consecutive patients treated with R-CHOP-21 arm at the same Department, starting from the most recent patient and going backwards (2005-2017).

Results: R-da-EPOCH was given strictly in 33/35 (94%) patients. The 5-year freedom from progression (FFP) was 91% vs. 69% (p = 0.027). The 5-year event-free survival (EFS) was 84% vs. 69% (p = 0.124). The 5-year overall survival (OS) was 97% vs. 80% (p = 0.063). Among R-CHOP-21-responders, 20/29 (69%) received RT compared to 2/34 (6%) R-da-EPOCH-responders. In multivariate analysis, R-da-EPOCH remained better than R-CHOP-21 in terms of FFP [hazard ratios (HRs) 0.21-0.26, all p < 0.05] and was associated with very favorable HR for EFS and OS.

Conclusions: Optimally delivered R-da-EPOCH minimized the use of RT in a real-life setting and provided superior outcomes than R-CHOP-21.

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最佳递送R-da-EPOCH与R-CHOP-21治疗原发性纵隔大b细胞淋巴瘤：单个学术中心的真实比较

背景/目的：美国国家癌症研究所在原发性纵隔大b细胞淋巴瘤（PMLBCL）中引入了强化R-da-EPOCH方案，以改善预后，同时最大限度地减少放疗的使用。然而，没有R-da-EPOCH与R-CHOP-21的随机比较。本研究的目的是比较R-da-EPOCH和R-CHOP-21在单个大型转诊中心的连续PMLBCL患者中的疗效，该转诊中心严格遵循R-da-EPOCH升级计划。方法：我们回顾性分析所有35例连续接受R-da-EPOCH治疗的患者（2017-2022），与同一科室连续35例接受R-CHOP-21治疗的患者进行比较，从最近的患者开始回溯（2005-2017）。结果：33/35例（94%）患者严格给予R-da-EPOCH治疗。5年无进展自由度（FFP）为91%对69% （p = 0.027）。5年无事件生存率（EFS）为84% vs. 69% （p = 0.124）。5年总生存率（OS）为97% vs 80% （p = 0.063）。在r - chop -21应答者中，20/29（69%）接受了RT，而r -da- epoch应答者中有2/34（6%）接受了RT。在多因素分析中，R-da-EPOCH在FFP方面仍优于R-CHOP-21[危险比（HR） 0.21-0.26，均p < 0.05]，并且与EFS和OS的非常有利的HR相关。结论：与R-CHOP-21相比，最佳递送R-da-EPOCH减少了现实生活中RT的使用，并提供了更好的结果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Cancers Medicine-Oncology

CiteScore

8.00

自引率

9.60%

发文量

5371

审稿时长

18.07 days

期刊介绍： Cancers (ISSN 2072-6694) is an international, peer-reviewed open access journal on oncology. It publishes reviews, regular research papers and short communications. Our aim is to encourage scientists to publish their experimental and theoretical results in as much detail as possible. There is no restriction on the length of the papers. The full experimental details must be provided so that the results can be reproduced.