It is unclear whether survival in diffuse large B-cell lymphoma (DLBCL) continues to increase in an era where rituximab-containing chemotherapy reigns for almost two decades. Therefore, we evaluated trends in primary therapy and relative survival (RS) among Dutch DLBCL patients diagnosed between 1989 and 2018. Analyses were performed separately according to the stage I (N = 6952) and stage II–IV disease (N = 20,676), stratified by calendar period and age (18–64, 65–74, and ≥75 years). The use of chemotherapy ± radiotherapy increased over time across all age and stage groups. As of the mid-2000s, >95% of chemotherapy-treated patients received chemoimmunotherapy, irrespective of age and stage. Overall, RS increased significantly over time across all age groups, especially after 2003 when rituximab-containing chemotherapy had become the standard of care. However, RS increased less pronounced between 2003–2010 and 2011–2018 than between 1989–2002 and 2003–2010. These findings were congruent across all studied stage groups. Five-year RS across the three age groups during 2011–2018 was 96%, 84%, and 67% for stage I DLBCL and 75%, 60%, and 46% for stage II–IV DLBCL. Collectively, survival in DLBCL increased modestly beyond the initial introduction of rituximab, with apparent survival differences across age and stage that warrant novel treatment approaches.
目前尚不清楚，在含利妥昔单抗的化疗主导近二十年的时代，弥漫性大B细胞淋巴瘤（DLBCL）患者的生存率是否持续提高。因此，我们评估了1989年至2018年间诊断的荷兰DLBCL患者在初始治疗和相对生存率（RS）方面的趋势。分析根据I期（N=6952）和II–IV期（N=20,676）疾病分别进行，并按日历时间段和年龄（18–64岁、65–74岁和≥75岁）分层。随时间推移，所有年龄和分期组中化疗±放疗的使用率均有所增加。自2000年代中期以来，>95%接受化疗的患者接受了化学免疫治疗，且不受年龄和分期影响。总体而言，各年龄组的RS随时间显著提高，尤其是在2003年含利妥昔单抗的化疗成为标准治疗之后。然而，2003–2010年与2011–2018年间的RS增长幅度较1989–2002年与2003–2010年间的增长更为缓和。这些发现在所有研究的分期组中表现一致。2011–2018年间，三个年龄组I期DLBCL的五年RS分别为96%、84%和67%，II–IV期DLBCL则分别为75%、60%和46%。总体而言，DLBCL的生存率在利妥昔单抗首次引入后仅略有提升，且不同年龄和分期之间存在明显的生存差异，这需要新的治疗方法来改善。
肿瘤(癌症)患者之家