使用Deauville评分来指导扩散大B细胞淋巴瘤的巩固性放射治疗
Chun En Yau1, Chen Ee Low1, Whee Sze Ong2
1Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Dr, Singapore 117597, Singapore.
Cancers
|October 16, 2024
概括
在PET-CT扫描中具有低Deauville分数 (DV1-3) 的扩散性大B细胞淋巴瘤 (DLBCL) 患者可能不需要巩固性放射治疗 (RT). 这一发现可以帮助低风险DLBCL患者避免不必要的RT.
科学领域:
- 在瘤学瘤学.
- 辐射疗法 辐射疗法
- 核医学就是核医学.
背景情况:
- 扩散性大B细胞淋巴瘤 (DLBCL) 是一种攻击性的成人淋巴瘤.
- 强化放射治疗 (RT) 是常见的,但其指导方针不清楚,冒着不必要的治疗风险.
- 评估治疗结束时的PET-CT扫描与Deauville分数 (DV) 可以指导RT决策并替代低风险患者.
研究的目的:
- 评估治疗结束PET-CT扫描 (DV) 在指导DLBCL整合性RT中的价值.
- 确定DV是否可以识别DLBCL患者,这些患者可能不会从RT中受益.
- 在低风险DLBCL患者中潜在地减少不必要的RT.
主要方法:
- 在2010年至2022年期间诊断出349名DLBCL患者的回顾性分析.
- 在一线化疗免疫治疗后,在治疗结束时PET-CT DV测量患者的纳入.
- 作为主要结果的时间到进展 (TTP),使用考克斯回归分析以评估基于DV的RT的预测值.
主要成果:
- 在DV4-5患者中,RT显著改善了TTP (HR 0.33,p=0.027) 但在DV1-3患者中没有 (HR 0.85,p=0.671).
- 多变量分析证实了RT对DV4-5患者的益处 (aHR 0.29,p=0.017) 但不是DV1-3患者 (aHR 0.86,p=0.707).
- 相互作用的p值为0.133 (单变) 和0.087 (多变),表明趋势,但在差异化治疗效果中没有统计意义.
结论:
- DLBCL患者在治疗结束时使用PET-CT DV1-3可能不需要整合性RT.
- 需要进一步的长期随访和潜在的随机试验.
- 在PET-CT上的DV评分显示了在DLBCL中个性化RT决策的潜力.
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