脂质体多柔比星、长春新碱和达卡巴嗪加残留结节肿块巩固放疗用于老年晚期典型霍奇金淋巴瘤患者的一线治疗：一项多中心真实生活研究改善了治疗效果。

IF 3.3 4区医学 Q2 HEMATOLOGY

Hematological Oncology Pub Date : 2024-11-17 DOI:10.1002/hon.70003

M. Picardi, A. Vincenzi, C. Giordano, L. De Fazio, N. Pugliese, A. Scarpa, E. Vigliar, G. Troncone, D. Russo, M. Mascolo, G. Esposito, M. Prastaro, C. Santoro, R. Esposito, C. G. Tocchetti, C. Mainolfi, R. Fonti, S. Del Vecchio, M. Carchia, C. Quagliano, A. Salemme, V. Damiano, R. Bianco, F. Trastulli, F. Ronconi, M. Annunziata, F. Pane

{"title":"脂质体多柔比星、长春新碱和达卡巴嗪加残留结节肿块巩固放疗用于老年晚期典型霍奇金淋巴瘤患者的一线治疗：一项多中心真实生活研究改善了治疗效果。","authors":"M. Picardi, A. Vincenzi, C. Giordano, L. De Fazio, N. Pugliese, A. Scarpa, E. Vigliar, G. Troncone, D. Russo, M. Mascolo, G. Esposito, M. Prastaro, C. Santoro, R. Esposito, C. G. Tocchetti, C. Mainolfi, R. Fonti, S. Del Vecchio, M. Carchia, C. Quagliano, A. Salemme, V. Damiano, R. Bianco, F. Trastulli, F. Ronconi, M. Annunziata, F. Pane","doi":"10.1002/hon.70003","DOIUrl":null,"url":null,"abstract":"In elderly patients with high-risk classic Hodgkin lymphoma (c-HL), we evaluated the impact of a new modality treatment without bleomycin, that is, liposomal doxorubicin (NPLD)-based regimen plus consolidation radiotherapy of residual nodal masses (RNMs), on overall survival (OS) and progression free survival (PFS). In this retrospective study (2013–2023) conducted in tertiary hospitals in the bay of Naples (Italy), 50 older adults (median age, 69 years; range, 60–89) with advanced stage c-HL received frontline treatment with MVD ± irradiation. MVD consisted of 25 mg/m2 of NPLD along with standard Vinblastine and Dacarbazine for a total of 6 cycles (twelve iv administrations, every 2 weeks) followed by radiation of RNMs with size ≥ 2.5 cm at computed tomography. Patients underwent MVD with a median dose intensity of 92%. At 2-deoxy-2[F-18] fluoro-D-glucose positron emission tomography (FDG-PET), 90% of patients (45/50 patients; one failed to perform final FDG-PET due to early death) reached complete responses. Altogether, 17 patients (34%) received consolidation radiotherapy of RNMs with Deauville score ≥ 3. At 5-year median follow-up, the OS and PFS of the entire population were 87.5% (95% confidence interval [CI], 78.7–97.4) and 81.6% (95% CI, 71.4–93.2), respectively. Eleven patients (22%) experienced grade ≥ 3 adverse events, and 4 of them required hospitalization. Our data suggest that in older adults with high-risk c-HL NPLD-driven strategy (without bleomycin) plus consolidation radiotherapy (if needed) may be a promising up-front option, to test in phase II clinical trials for improving survival incidence.","PeriodicalId":12882,"journal":{"name":"Hematological Oncology","volume":"42 6","pages":""},"PeriodicalIF":3.3000,"publicationDate":"2024-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/hon.70003","citationCount":"0","resultStr":"{\"title\":\"Liposomal Doxorubicin, Vinblastine and Dacarbazine Plus Consolidation Radiotherapy of Residual Nodal Masses for Frontline Treatment in Older Adults With Advanced Stage Classic Hodgkin Lymphoma: Improved Outcome in a Multi-Center Real-Life Study\",\"authors\":\"M. Picardi, A. Vincenzi, C. Giordano, L. De Fazio, N. Pugliese, A. Scarpa, E. Vigliar, G. Troncone, D. Russo, M. Mascolo, G. Esposito, M. Prastaro, C. Santoro, R. Esposito, C. G. Tocchetti, C. Mainolfi, R. Fonti, S. Del Vecchio, M. Carchia, C. Quagliano, A. Salemme, V. Damiano, R. Bianco, F. Trastulli, F. Ronconi, M. Annunziata, F. Pane\",\"doi\":\"10.1002/hon.70003\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"In elderly patients with high-risk classic Hodgkin lymphoma (c-HL), we evaluated the impact of a new modality treatment without bleomycin, that is, liposomal doxorubicin (NPLD)-based regimen plus consolidation radiotherapy of residual nodal masses (RNMs), on overall survival (OS) and progression free survival (PFS). In this retrospective study (2013–2023) conducted in tertiary hospitals in the bay of Naples (Italy), 50 older adults (median age, 69 years; range, 60–89) with advanced stage c-HL received frontline treatment with MVD ± irradiation. MVD consisted of 25 mg/m2 of NPLD along with standard Vinblastine and Dacarbazine for a total of 6 cycles (twelve iv administrations, every 2 weeks) followed by radiation of RNMs with size ≥ 2.5 cm at computed tomography. Patients underwent MVD with a median dose intensity of 92%. At 2-deoxy-2[F-18] fluoro-D-glucose positron emission tomography (FDG-PET), 90% of patients (45/50 patients; one failed to perform final FDG-PET due to early death) reached complete responses. Altogether, 17 patients (34%) received consolidation radiotherapy of RNMs with Deauville score ≥ 3. At 5-year median follow-up, the OS and PFS of the entire population were 87.5% (95% confidence interval [CI], 78.7–97.4) and 81.6% (95% CI, 71.4–93.2), respectively. Eleven patients (22%) experienced grade ≥ 3 adverse events, and 4 of them required hospitalization. Our data suggest that in older adults with high-risk c-HL NPLD-driven strategy (without bleomycin) plus consolidation radiotherapy (if needed) may be a promising up-front option, to test in phase II clinical trials for improving survival incidence.\",\"PeriodicalId\":12882,\"journal\":{\"name\":\"Hematological Oncology\",\"volume\":\"42 6\",\"pages\":\"\"},\"PeriodicalIF\":3.3000,\"publicationDate\":\"2024-11-17\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://onlinelibrary.wiley.com/doi/epdf/10.1002/hon.70003\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Hematological Oncology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1002/hon.70003\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"HEMATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Hematological Oncology","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1002/hon.70003","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"HEMATOLOGY","Score":null,"Total":0}

引用次数: 0

摘要

在高风险典型霍奇金淋巴瘤（c-HL）老年患者中，我们评估了不使用博莱霉素的新模式治疗（即基于脂质体多柔比星（NPLD）的方案加上残留结节肿块（RNM）的巩固放疗）对总生存期（OS）和无进展生存期（PFS）的影响。这项回顾性研究（2013-2023年）在意大利那不勒斯海湾的三级医院进行，50名患有晚期c-HL的老年人（中位年龄69岁；范围60-89岁）接受了MVD±照射的一线治疗。MVD包括25毫克/平方米的NPLD以及标准的长春新碱和达卡巴嗪，共6个周期（12次静脉注射，每2周一次），然后对计算机断层扫描显示大小≥2.5厘米的RNM进行放射治疗。患者接受的 MVD 中位剂量强度为 92%。在 2-脱氧-2[F-18]氟-D-葡萄糖正电子发射断层扫描（FDG-PET）中，90%的患者（45/50 例；1 例因早期死亡未能进行最终的 FDG-PET）达到完全反应。共有17名患者（34%）接受了多维尔评分≥3的RNMs巩固放疗。在5年的中位随访中，全部患者的OS和PFS分别为87.5%（95%置信区间[CI]，78.7-97.4）和81.6%（95%置信区间[CI]，71.4-93.2）。11名患者（22%）出现了≥3级不良反应，其中4人需要住院治疗。我们的数据表明，对于患有高危c-HL的老年人，NPLD驱动策略（不使用博莱霉素）加巩固放疗（如需要）可能是一种很有前景的前期选择，可在II期临床试验中进行检验，以提高生存率。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

Liposomal Doxorubicin, Vinblastine and Dacarbazine Plus Consolidation Radiotherapy of Residual Nodal Masses for Frontline Treatment in Older Adults With Advanced Stage Classic Hodgkin Lymphoma: Improved Outcome in a Multi-Center Real-Life Study

查看原文本刊更多论文

In elderly patients with high-risk classic Hodgkin lymphoma (c-HL), we evaluated the impact of a new modality treatment without bleomycin, that is, liposomal doxorubicin (NPLD)-based regimen plus consolidation radiotherapy of residual nodal masses (RNMs), on overall survival (OS) and progression free survival (PFS). In this retrospective study (2013–2023) conducted in tertiary hospitals in the bay of Naples (Italy), 50 older adults (median age, 69 years; range, 60–89) with advanced stage c-HL received frontline treatment with MVD ± irradiation. MVD consisted of 25 mg/m² of NPLD along with standard Vinblastine and Dacarbazine for a total of 6 cycles (twelve iv administrations, every 2 weeks) followed by radiation of RNMs with size ≥ 2.5 cm at computed tomography. Patients underwent MVD with a median dose intensity of 92%. At 2-deoxy-2[F-18] fluoro-D-glucose positron emission tomography (FDG-PET), 90% of patients (45/50 patients; one failed to perform final FDG-PET due to early death) reached complete responses. Altogether, 17 patients (34%) received consolidation radiotherapy of RNMs with Deauville score ≥ 3. At 5-year median follow-up, the OS and PFS of the entire population were 87.5% (95% confidence interval [CI], 78.7–97.4) and 81.6% (95% CI, 71.4–93.2), respectively. Eleven patients (22%) experienced grade ≥ 3 adverse events, and 4 of them required hospitalization. Our data suggest that in older adults with high-risk c-HL NPLD-driven strategy (without bleomycin) plus consolidation radiotherapy (if needed) may be a promising up-front option, to test in phase II clinical trials for improving survival incidence.

求助全文

通过发布文献求助，成功后即可免费获取论文全文。去求助

来源期刊

Hematological Oncology 医学-血液学

CiteScore

4.20

自引率

6.10%

发文量

147

审稿时长

>12 weeks

期刊介绍： Hematological Oncology considers for publication articles dealing with experimental and clinical aspects of neoplastic diseases of the hemopoietic and lymphoid systems and relevant related matters. Translational studies applying basic science to clinical issues are particularly welcomed. Manuscripts dealing with the following areas are encouraged: -Clinical practice and management of hematological neoplasia, including: acute and chronic leukemias, malignant lymphomas, myeloproliferative disorders -Diagnostic investigations, including imaging and laboratory assays -Epidemiology, pathology and pathobiology of hematological neoplasia of hematological diseases -Therapeutic issues including Phase 1, 2 or 3 trials as well as allogeneic and autologous stem cell transplantation studies -Aspects of the cell biology, molecular biology, molecular genetics and cytogenetics of normal or diseased hematopoeisis and lymphopoiesis, including stem cells and cytokines and other regulatory systems. Concise, topical review material is welcomed, especially if it makes new concepts and ideas accessible to a wider community. Proposals for review material may be discussed with the Editor-in-Chief. Collections of case material and case reports will be considered only if they have broader scientific or clinical relevance.