Impact of Omission/Reduction of Vincristine From R-CHOP in Treatment of DLBCL
| Autor: | Naoko Tsuyama, Naoki Mori, Kengo Takeuchi, Hirofumi Yamauchi, Noriko Nishimura, Tetsuya Ogawa, Masahiro Yokoyama, Shoko Marshall, Norihito Inoue, Hiroshi Sakura, Yasuhito Terui, Yuko Mishima, Toshie Ogasawara |
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| Rok vydání: | 2020 |
| Předmět: |
Oncology
Adult Male Cancer Research medicine.medical_specialty Vincristine Cyclophosphamide medicine.medical_treatment Clinical Decision-Making 03 medical and health sciences Young Adult 0302 clinical medicine immune system diseases hemic and lymphatic diseases Internal medicine Antineoplastic Combined Chemotherapy Protocols medicine Humans Adverse effect Aged Neoplasm Staging Aged 80 and over Chemotherapy business.industry Disease Management Hematology Middle Aged medicine.disease Prognosis Survival Analysis Lymphoma Regimen Treatment Outcome Doxorubicin 030220 oncology & carcinogenesis Prednisolone Prednisone Rituximab Female Lymphoma Large B-Cell Diffuse business 030215 immunology medicine.drug |
| Zdroj: | Clinical lymphoma, myelomaleukemia. 21(3) |
| ISSN: | 2152-2669 |
| Popis: | The R-CHOP regimen (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone) is the standard therapy for patients with diffuse large B-cell lymphoma (DLBCL). However, vincristine is sometimes omitted or reduced owing to side effects.We retrospectively reviewed newly diagnosed patients with DLBCL with R-CHOP-like chemotherapy in our institute from January 2005 to February 2018 to investigate whether the omission/reduction of vincristine reduced the efficacy of the treatment. We compared the overall survival (OS) with and without the omission/reduction of vincristine from the R-CHOP regimen.A total of 576 cases were reviewed, and vincristine was omitted/reduced in 50 (9%) patients. The 4-year OS with and without vincristine omission/reduction for relative dose intensity 80%, 50%, and 25% was 70% versus 82% (P = .035), 70% versus 82% (P = .085), and 53% versus 82% (P = .0007). In a multivariate analysis, adjusting for international prognostic index risk factors, a statistically significant, poor OS was indicated in the patients with relative dose intensity 25%.Excessive dose omission/reduction of vincristine might lead to a substantial loss of efficacy of R-CHOP therapy. |
| Databáze: | OpenAIRE |
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