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目的分析利妥昔单抗治疗淋巴瘤的远期疗效及中期PET/CT评估的意义。方法收集191例淋巴瘤患者资料;其中,利妥昔单抗治疗108例(A组),非利妥昔单抗治疗83例(B组)。回顾性分析利妥昔单抗治疗淋巴瘤的远期临床效果及其患者预后的影响因素。结果与B组比较,A组完全缓解(CR)率较高(94.4%vs.83.1%)(P<0.05),复发率较低(6.4%vs.22.9%)(P<0.01),5年生存率较高(65.7%vs.44.6%)(P<0.05)。利妥昔单抗诱导治疗CR后且维持其治疗组的5年生存率高于中断其治疗组(85.5%vs.50.0%)(P<0.05)。侵袭性淋巴瘤患者采用含利妥昔单抗治疗者的5年生存率高于非利妥昔单抗治疗者(61.7%vs.38.6%)(P<0.05)。行中期PET/CT检查患者的5年生存率高于未行者(66.7%vs.53.7%)(P<0.05)。HBsAg阳性、年龄>65岁、β2微球蛋白升高、免疫分型(如弥漫大B细胞淋巴瘤)和有颅内侵犯是预后不良的因素(P<0.05)。结论利妥昔单抗可提高淋巴瘤患者CR率,减少复发。首选利妥昔单抗达CR后维持其治疗能明显改善预后。实施中期PET/CT检查有利于评估化疗疗效,选择更为合理的化疗方案。
Objective To analyze the long-term efficacy of rituximab in the treatment of lymphoma and the significance of midterm PET / CT evaluation. Methods The data of 191 patients with lymphoma were collected. Among them, 108 patients (group A) received rituximab and 83 patients who received non-rituximab (group B). Retrospective analysis of rituximab in the treatment of lymphoma long-term clinical effects and prognosis of patients with factors. Results Compared with group B, the complete remission (CR) rate was significantly higher in group A than in group B (94.4% vs 83.3%, P <0.05), and the recurrence rate was lower (6.4% vs.22.9% The survival rate was higher (65.7% vs.44.6%) (P <0.05). Rituximab-induced CR after treatment and maintain its 5-year survival rate was higher than the treatment group (85.5% vs. 50.0%) (P <0.05). The 5-year survival rate of patients with invasive lymphoma who received rituximab was significantly higher than that of non-rituximab-treated patients (61.7% vs.38.6%, P <0.05). The 5-year survival rate of patients undergoing metaphase PET / CT examination was higher than that of those without (66.7% vs.53.7%) (P <0.05). HBsAg positive, age> 65 years, β2 microglobulin increased, immunophenotyping (such as diffuse large B cell lymphoma) and intracranial invasion is a poor prognostic factor (P <0.05). Conclusion Rituximab can improve the CR rate and reduce the relapse in patients with lymphoma. Rituximab preferred CR maintenance of its treatment can significantly improve the prognosis. The implementation of mid-term PET / CT examination is conducive to assess the efficacy of chemotherapy, choose a more reasonable chemotherapy.