| Objective:To investigate the clinical features of diffuse large B cell lymphoma in Shantou and to compare the efficacy and adverse reaction of CHOP and CHOEP regimens on diffuse large B cell lymphoma, that could be useful and important for clinical reference.Methods: Total 39 patients of diffuse large B cell lymphoma initially treated in the second affiliated hospital of Shantou University medical college from January 2003 to January 2009 were reviewed to investigate the clinical features and to compare the efficacy and adverse reaction by different treatment. All patients were divided into 2 groups according to different treatment. There were 19 cases in group CHOP and 20 in group CHOEP.Results: (1)There were 28 males and 11 females in total 39 patients, the ratio was 2.54:1. The youngest was 17 years-old and the eldest one was 84 years-old,the meta-age was 61 years old and the mean age was 53.6 years-old in 39 cases. There were 14 patients (35.9%) scored 1 for ECOG performance status, 23(58.9%) scored 2 and 2(5.1%) scored 3.First symptom: 23(58.9%) cases of system superficial lymphadenopathy; 7(17.9%) cases fever; 5(12.8%) cases of emaciation; 1 case of skin bumps ; 1 case of abdominal pain;1 case of abdominal mass; 1 caseof dyspnea . Extra-Lymphaden invasion: 6(15.4%) cases of liver invasion; 6(15.4%) cases of bone marrow invasion;3(7.7%) cases of spleen invasion;1(2.6%) cases of lung invasion;10(25.6%) cases of mediastinal or abdominal invasion. There are 33(84.6%) cases of LDH abnormity and 28(71.8%) cases of ESR abnormity.(2)The complete remission rate was 75.0% in group CHOEP which was higher than the complete remission rate 31.6% in group CHOP (P=0.01).(3)The total remission rate was 95.0% in group CHOEP and was 78.9% in group CHOP, there was no significant difference in the two groups(P>0.05). (4)The 2-year survival rate was 55.0% in group CHOEP and was 47.4% in group CHOP, there was no significant difference in the two groups(P>0.05).(5)There was no significant difference of the adverse reaction in the two groups((P>0.05).Conclusions:(1) Diffuse large B cell lymphoma can attack all the patients in different ages, but mainly in old ages, males are more than females in incidence. There can be abundant of first symptoms, system superficial lymphadenopathy is the most one, fever or emaciation can be the second. It is common for the extra-lymphmaden invasion in diffuse lage B cell lymphoma, mainly to livers and bone marrow. Most of the patients can be found with LDH or ESR abnormity by laboratory examination. This tumor is aggressive and moderate-excessive malignant as well as difficult in treating with a 2-years survival rate 45%`55%. Chemotherapy can be curative, but there is high risk of recurrence and resistance.(2)For the initially treated patients of diffuse large B cell lymphoma,though there was no significant difference in remission and 2-years survival rate in CHOEP and CHOP regimens, the complete remission of group CHOEP was much higher than group CHOP without a clinically significant increase in toxicity. CHOEP regimens is curative and safe treatment for diffuse large B cell lymphoma.(3) Because it was a sample less and Shantou localized research, the result of this research is different with other ones in China and abroad. It is necessary for more hard work and a further research in the future. |
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