演題詳細

ポスター / Poster

ポスター 26 (Poster 26) :B細胞性リンパ腫:Chemotherapy

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日程
2013年10月11日(金)
時間
16:50 - 17:50
会場
ポスター会場 / Poster (ロイトン札幌 3F ロイトンホールABCD)
座長・司会
塚本 憲史 (Norifumi Tsukamoto):1
1:群馬大学医学部附属病院 腫瘍センター
 
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Dose-intensity of CHOP-like regimens in elderly-DLBCL patients: A retrospective CGA-based analysis

演題番号 : PS-1-189

小澤 孝幸 (Takayuki Ozawa):1、小杉 智 (Satoru Kosugi):1、大西 麻由 (Mayu Onishi):1、木田 亨 (Toru Kida):1、中田 壮一 (Soichi Nakata):1、武 弘典 (Hironori Take):1、片桐 修一 (Syuichi Katagiri):1

1:Department of Internal Medicine (Hematology), Toyonaka Municipal Hospital, Toyonaka, Japan

 

BACKGROUND:Most elderly patients with DLBCL were initially treated with reduced-dose CHOP-like regimens. However, optimal dose-reduction strategy has not been established. Recently, Comprehensive Geriatric Assessment (CGA) has been proposed (Tucci et.al., 2009). Using the CGA, we analyzed our practice retrospectively. PATIENTS AND RESULTS: 60 DLBCL patients over 65-y.o. from Jan-2007 to Dec-2011 were analysed. According to CGA, 29 were " fit", and 31 were " unfit". All " fit" and 26 out of the 31 " unfit" were treated by CHOP-like regimens. Relative-dose-intensity (RDI) in " fit" (76.1%) was significantly higher than RDI in " unfit" (60.5%; Mann-Whitney's U-test), but was far from 100%. In the " fit", survival at 1-year/3-year was 100%/93.1%, and CR/PR rate at 1-year/3-year was 89.7%/86.2%. In the " unfit", 1-year/3-year survival of the CHOP-treated was 73.1%/65.4%, that seemed to be better than the survival of " unfit" patients Tucci reported (about 20-40%). On the other hand, CR/PR rate at 1-year in our " unfit" patients with 70%=< of RDI was significantly lower than in patients with 70%> of RDI (42.9% vs. 87.5%; p=0.03, Fisher's test). This was apparently due to 2 cardiac deaths in patients with 70%=< of RDI. DISCUSSION: Though our treatment to " fit" may be insufficient, short term observation showed no inferiority. Though Tucci recommended CVP to " unfit", our results suggested that some anthracycline use might provide benefit. From 2 cardiac deaths in our "unfit" patients with 70%=< of RDI, we think dose-intensity of anthracyclines should not exceed 70%.

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