ABSTRACT
Objective:To compare the efficacy and safety of pegylated liposomal Doxorubicin(PLD)and Epirubicin(EPI)as first-line chemotherapy for diffuse large B-cell lymphoma(DLBCL).Methods:Clinical data of DLBCL patients treated at Zhejiang Cancer Hospital from March 2013 to April 2018 were retrospectively collected.A total of 411 patients who had received first-line chemotherapy were included.Based on age, sex, Ann Arbor staging and other parameters and using the PSM method for 1∶1 matching, 151 patients were assigned into each of the PLD group and the EPI group.Efficacy and adverse events were compared between the PLD group and the EPI group.All patients were followed up for 3 years after treatment to monitor survival.Results:The complete response(CR)rate in the PLD group was 81.5%, and the CR rate in the EPI group was 72.2%.The objective response rate(ORR)of the PLD group was 98%, and the ORR of the EPI group was 96.7%.There was no significant difference in CR rate( χ2=0.478, P=0.489)or ORR between the two groups( χ2=0.007, P=0.934). In the PLD group, myelosuppression occurred in 25 cases(16.6%)and cardiotoxicity-related events in 21 cases(13.9%); in the EPI group, there were 24 cases(15.9%)of myelosuppression and the same number of cases of cardiotoxicity-related events, and there were no significant differences in myelosuppression( χ2=0.018, P=0.895)or cardiotoxicity( χ2=0.174, P=0.677)between the two groups.During the 3-year follow-up, the progression free survival(PFS)rates of the PLD group and the EPI group were 79.1% and 69.6%, respectively, with a statistically significant difference between the two groups( χ2=3.930, P=0.047). Both the PLD group and the EPI group had a 3-year OS rate of 85.2%, with no statistically significant difference between the two groups( χ2=0.402, P=0.538). Conclusions:The 3-year progression-free survival of DLBCL patients with PLD as first-line chemotherapy is significantly better than with EPI, and the 3-year overall survival, short-term efficacy and myelosuppression are comparable to those with EPI.
ABSTRACT
Colorectal cancer patients with potential resectable liver metastases may benefit from hepatectomy or other local treatment to achieve R 0 resection or no evidence disease after conversion treatment by chemotherapy with or without target therapy. FOLFOX or FOLFIRI combined with cetuximab is appropriate for RAS and BRAF wide type and primary tumor at left-side colon cancer and rectal cancer. It is complex for RAS and BRAF wide type and primary tumor at right-side colon cancer or RAS or BRAF mutated patients. FOLFOXIRI combined with bevacizumab may be the first choice for those patients with young age and good performance score to achieve best conversion chance, while FOLFOX/CapeOx/FOLFIRI combined with bevacizumab could be the second choice. A surgical re-evaluation should be planned every 2 months after initiation of conversion treatment in multi-disciplinary treatment assessment. Once it is demonstrated conversion treatment is successful, surgery should be performed as soon as possible.
