Retrospective Analysis:Therapeutic Effects And Prognostic Factors Of Different Treatment Methods For Primary Gastric Diffuse Large B-cell Lymphoma

Objective:To analyze the differences in the therap euticeffects of primary gastric diffuse large B-cell lymphoma(PG-DLBCL) and the quality of life of patients,and to explore the prognostic factors.Methods:Collect and summarize the clinical data of patients with PG-DLBCL that were confirmed by gastroscope biopsy or surgical specimen histopathology during the period from January1,2009 to July30,2016 in our hospital.According to different treatment methods,they were divided into simple chemotherapy group,surgery + chemotherapy group,radiotherapy and chemotherapy group,surgery + radiotherapy and chemotherapy group,and analyzed the efficacy of each group and the factors influencing its prognosis.The data were entered using Excel,statistical analysis was performed using SPSS22.0 software,Kaplan-Meier method was used to calculate survival rate and single factor analysis,Log-ranktest was used to compare differences between groups,and meaningful single factor was used to carry out Cox proportional hazards model.Analyze and look for independent factors that affect its prognosis.Measured data were expressed as mean±standard deviation,and independent samples t-test was used for comparison between groups.There was a statistical difference with P<0.05.Results:Recent efficacy analysis:The ORR of the chemotherapy alone group,the surgery+chemotherapy group,the radiochemotherapy group,and the surgery+ radiotherapy group were 84.6%,83.3%,90%,and 100%,respectively,and the difference was not statistically significant(x~2=2.629,P=0.452).DCR were 92.3%,88.9%,100%,and 100%,respectively,with no statistically significant difference(x~2=2.113,P=0.549),(P>0.05). Long-term efficacy analysis:The 1-year,3-year,and5-year survival rates for the whole group were 96.0%,91.6%,and85.3%.The one-year survival rates for the chemotherapy alone group,the surgery+chemotherapy group,the radiochemotherapy group,and the surgery+radiotherapy group were 92.3%,respectively.100%,90.0%,and100%,the 3-year survival rates were 82.1%,100%,90.0%,and 88.9%,respectively.The 5-year survival rates were82.1%,83.1%,90.0%,and 88.9%,respectively,with no statistical difference.(P>0.05).The body mass index BMI of the non-surgical treatment group(chemotherapy group,radiochemotherapy group)was higher than the surgical treatment group(surgery + chemotherapy group,surgery + radiotherapy and chemotherapy group),the difference was statistically significant(P<0.05).Univariate analysis:LDH,β2-MG,ALB,IPI score,PS score,B symptom,Lugano stage and age were the influencing factors of prognosis of PG-DLBCL at the time of initial diagnosis,and the difference was statistically significant(P<0.05).The anemia,sex,and tumor cell source had no effect on the prognosis of PG-DLBCL,and the difference was not statistically significant(P>0.05).Multi-factors analysis:According to Cox regression analysis,IPI score,PS score and Lgano staging were independent factors of PG-DLBCL prognosis(P<0.05).Conclusion:1、In non-surgical treatment,chemotherapy combined with radiotherapy is effective,disease control rate is high,and has a high survival rate.It is the best treatment for gastric organ preservation in PG-DLBCL.Non-surgical treatment has better quality of life than surgical treatment.2、IPI score,B symptoms,β2-MG,ALB,LDH,Lugano staging,PS scores and age are the factors that affect the prognosis of PG-DLBCL. 3、IPI score,PS score and Lgano stage are independent factors of PG-DLBCL prognosis.