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A study on the prevention of hemorrhage and perforation in patients with primary gastric diffuse large-B cell lymphoma during treatment with immunochemotherapy

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单位: [1]Department of Medical Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in Southern China, and Collaborative Innovation Center of Cancer Medicine, Guangzhou, China [2]Department of Medical Oncology, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China [3]Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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关键词: hemorrhage perforation primary gastric diffuse large B-cell lymphoma R-CHOP

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Background: Stomach hemorrhage and perforation are very severe and com-mon complications in patients with primary gastric diffuse large B -cell lym-phoma (PG-DLBCL) during treatment with immunochemotherapy. However, no relevant clinical studies have been performed on the prevention of these serious complications.Methods: Patients diagnosed with PG- DLBCL were enrolled in this retrospective study. The prevention group received standard rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone (R- CHOP) treatment without prednisone combined with antacids and anti-Helicobacter pylori (Hp) therapy. These patients received R- CHOP- based treatment until the complete recovery of gastric ulcers, as proven by gastroscopy. The control group received a standard R- CHOP regimen. Toxicity and survival were the main endpoints.Results: A total of 52 patients received preventative treatment, while 146 patients did not. Among patients with stage I, II -1, and II -2 disease, the prevention group had a lower rate of hemorrhage and perforation (0/40) than the control group (10/78, p = 0.044). At a median follow- up time of 25 months, the 5- year event- free survival (EFS) rates were 97.1% in the prevention group and 66.1% in the control group (p = 0.025), and the 5- year overall survival (OS) rates were 100% and 72.0%, respectively (p = 0.021). However, the differences in the 5- year EFS and OS of patients with disseminated disease were not statistically significant.Conclusions: Preventative treatment can decrease the risk of hemorrhage and perforation in patients with localized PG- DLBCL during immunochemotherapy, leading to better EFS and OS in these patients. However, preventative treatment failed to reduce the risk of gastric hemorrhage and perforation and did not im-prove survival (EFS and OS) in advanced- stage patients.

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出版当年[2022]版:
大类 | 3 区 医学
小类 | 3 区 肿瘤学
最新[2025]版:
大类 | 3 区 医学
小类 | 3 区 肿瘤学
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出版当年[2021]版:
Q2 ONCOLOGY
最新[2023]版:
Q2 ONCOLOGY

影响因子: 最新[2023版] 最新五年平均 出版当年[2021版] 出版当年五年平均 出版前一年[2020版] 出版后一年[2022版]

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第一作者单位: [1]Department of Medical Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in Southern China, and Collaborative Innovation Center of Cancer Medicine, Guangzhou, China
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通讯机构: [1]Department of Medical Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in Southern China, and Collaborative Innovation Center of Cancer Medicine, Guangzhou, China [2]Department of Medical Oncology, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China [*1]Department of Medical Oncology, Sun Yat-sen UniversityCancer Center, Guangzhou, State KeyLaboratory of Oncology in SouthernChina, and Collaborative InnovationCenter of Cancer Medicine, 651Dongfeng Road East, Guangzhou, Guangdong 510060, China.
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