• 四川大學(xué)華西醫(yī)院,成都,610041;

目的 　為1例初診的老年彌漫性大B細(xì)胞淋巴瘤患者制定循證化療方案.
方法 　在充分評(píng)估患者病情的基礎(chǔ)上,提出臨床問(wèn)題,從PubMed(1990年1月～2004年12月)和SUMsearch上進(jìn)行檢索.
結(jié)果 　共檢索出關(guān)于臨床化療方案的隨機(jī)對(duì)照試驗(yàn)11篇及系統(tǒng)評(píng)價(jià)8篇,其中衛(wèi)生經(jīng)濟(jì)學(xué)評(píng)估的系統(tǒng)評(píng)價(jià)1篇.通過(guò)分析檢索結(jié)果,并結(jié)合患者實(shí)際情況,為患者制定出循證治療方案.經(jīng)5個(gè)月的隨訪證實(shí),該方案適合患者.
結(jié)論 　采用循證醫(yī)學(xué)的方法為初治的老年彌漫性大B細(xì)胞淋巴瘤患者制定化療方案可有效提高治療效果.

引用本文： 林秀芳,董碧蓉,李 峻. 1例老年彌漫性大B細(xì)胞淋巴瘤的循證治療. 中國(guó)循證醫(yī)學(xué)雜志, 2005, 05(4): 347-349. doi: 復(fù)制

1. Jaffe ES, Harris NL, Stein H, Vardiman JW. World Health Organization classification of tumours: pathology and genetics of tumours of haematopoietic and lymphoid tissues. Lyon, France: International Agency for Research on Cancer. 2001.
2. Kimby E, Brandt L, Nygren P. A systematic overview of chemotherapy effects in aggressive non-Hodgkin’s lymphoma[J]. Acta Oncol, 2001; 40(2-3): 198-212.
3. Fisher RI, Gaynor ER, Dahlberg S, Oken MM, Grogan TM, Mize EM, Glick JH, Coltman CA Jr, Miller TP.Comparison of a standard regimen (CHOP) with three intensive chemotherapy regimens for advanced non-Hodgkin’s lymphoma[J]. N Engl J Med, 1993; 328(14): 1 002-1 006.
4. Tilly H, Lepage E, Coiffier B. A randomized comparison of ACVBP and CHOP in the treatment of advanced aggressive non-Hodgkin’s lymphoma: the LNH93-5 study[J]. Blood, 2000; 96: 832a. abstract.
5. Kouroukis CT, Browman GP, Esmail R, Meyer RM. Chemotherapy for older patients with newly diagnosed, advanced-stage, aggressive-histology non-Hodgkin lymphoma: a systematic review[J]. Ann Intern Med, 2002; 15; 136(2): 144-152.
6. No authors listed.Rituximab: new indication. In aggressive non Hodgkin lymphoma: benefits must be confirmed[J].Prescrire Int, 2003; 12(66): 125-126.
7. W(o")hrer SR. Cyclophosphamide,doxorubicin,vincristine and prednisone (R-CHOP) for treatment of early-stage gastric diffuse large-B-cell lymphoma[J]. Ann Oncol, 2004;15(7): 1 086-1 090.
8. Portlock CS. Rituximab and CHOP for elderly patients with diffuse large-B-cell lymphoma[J]. Curr Oncol Rep, 2003; 5(5): 357.
9. Pettengell R, Linch D. Position paper on the therapeutic use of rituximab in CD20-positive diffuse large B-cell non-Hodgkins lymphoma[J]. Br J Haematol, 2003; 121(1): 44-48.
10. Kimby E, Brandt L, Nygren P, Glimelius B; SBU-group.A systematic overview of chemotherapy effects in aggressive non-Hodgkins lymphoma[J]. Acta Oncol, 2001; 40(2-3): 198-212.
11. Coiffier B.Immunochemotherapy: the new standard in aggressive non-Hodgkins lymphoma in the elderly[J]. Semin Oncol, 2003; 30(1 Suppl 2): 21-27.
12. Coiffier B, Lepage E, Briere J.CHOP Chemotherapy plus Rituximab Compared with CHOP Alone in Elderly Patients with Diffuse Large-B-Cell Lymphoma[J]. N Engl J Med, 2002; 346(4): 235-242.
13. Hannaford P. Rituximab plus CHOP for diffuse large-B-Cell lymphoma[J]. N Engl J Med, 2002; 346(23): 1 830-1 831.
14. The International Non-Hodgkins Lymphoma Prognostic Factors Project. A predictive model for aggressive non-Hodgkins lymphoma[J]. N Engl J Med, 1993; 329(14): 987-994.
15. Cancer Therapy Evaluation Program. Common toxicity criteria[M], version2.0. Bethesda, Md.: National Cancer Institute, March 1998.
16. Knight C, Hind D, Brewer N, Abbott V. Rituximab (MabThera) for aggressive non-Hodgkins lymphoma: systematic review and economic evaluation[J]. Health Technol Assess, 2004; 8(37): iii, ix-xi,1-82.
17. Heson BD, Horning SJ, Coiffier B. Report of an international workshop to standardize response criteria for non-Hodgkin’s lymphomas[J]. J Clin Oncol, 1999; 17: 1 244. [Erratum,] J Clin Oncol 2000; 18: 2 351.
  1. 1. Jaffe ES, Harris NL, Stein H, Vardiman JW. World Health Organization classification of tumours: pathology and genetics of tumours of haematopoietic and lymphoid tissues. Lyon, France: International Agency for Research on Cancer. 2001.
  2. 2. Kimby E, Brandt L, Nygren P. A systematic overview of chemotherapy effects in aggressive non-Hodgkin’s lymphoma[J]. Acta Oncol, 2001; 40(2-3): 198-212.
  3. 3. Fisher RI, Gaynor ER, Dahlberg S, Oken MM, Grogan TM, Mize EM, Glick JH, Coltman CA Jr, Miller TP.Comparison of a standard regimen (CHOP) with three intensive chemotherapy regimens for advanced non-Hodgkin’s lymphoma[J]. N Engl J Med, 1993; 328(14): 1 002-1 006.
  4. 4. Tilly H, Lepage E, Coiffier B. A randomized comparison of ACVBP and CHOP in the treatment of advanced aggressive non-Hodgkin’s lymphoma: the LNH93-5 study[J]. Blood, 2000; 96: 832a. abstract.
  5. 5. Kouroukis CT, Browman GP, Esmail R, Meyer RM. Chemotherapy for older patients with newly diagnosed, advanced-stage, aggressive-histology non-Hodgkin lymphoma: a systematic review[J]. Ann Intern Med, 2002; 15; 136(2): 144-152.
  6. 6. No authors listed.Rituximab: new indication. In aggressive non Hodgkin lymphoma: benefits must be confirmed[J].Prescrire Int, 2003; 12(66): 125-126.
  7. 7. W(o")hrer SR. Cyclophosphamide,doxorubicin,vincristine and prednisone (R-CHOP) for treatment of early-stage gastric diffuse large-B-cell lymphoma[J]. Ann Oncol, 2004;15(7): 1 086-1 090.
  8. 8. Portlock CS. Rituximab and CHOP for elderly patients with diffuse large-B-cell lymphoma[J]. Curr Oncol Rep, 2003; 5(5): 357.
  9. 9. Pettengell R, Linch D. Position paper on the therapeutic use of rituximab in CD20-positive diffuse large B-cell non-Hodgkins lymphoma[J]. Br J Haematol, 2003; 121(1): 44-48.
  10. 10. Kimby E, Brandt L, Nygren P, Glimelius B; SBU-group.A systematic overview of chemotherapy effects in aggressive non-Hodgkins lymphoma[J]. Acta Oncol, 2001; 40(2-3): 198-212.
  11. 11. Coiffier B.Immunochemotherapy: the new standard in aggressive non-Hodgkins lymphoma in the elderly[J]. Semin Oncol, 2003; 30(1 Suppl 2): 21-27.
  12. 12. Coiffier B, Lepage E, Briere J.CHOP Chemotherapy plus Rituximab Compared with CHOP Alone in Elderly Patients with Diffuse Large-B-Cell Lymphoma[J]. N Engl J Med, 2002; 346(4): 235-242.
  13. 13. Hannaford P. Rituximab plus CHOP for diffuse large-B-Cell lymphoma[J]. N Engl J Med, 2002; 346(23): 1 830-1 831.
  14. 14. The International Non-Hodgkins Lymphoma Prognostic Factors Project. A predictive model for aggressive non-Hodgkins lymphoma[J]. N Engl J Med, 1993; 329(14): 987-994.
  15. 15. Cancer Therapy Evaluation Program. Common toxicity criteria[M], version2.0. Bethesda, Md.: National Cancer Institute, March 1998.
  16. 16. Knight C, Hind D, Brewer N, Abbott V. Rituximab (MabThera) for aggressive non-Hodgkins lymphoma: systematic review and economic evaluation[J]. Health Technol Assess, 2004; 8(37): iii, ix-xi,1-82.
  17. 17. Heson BD, Horning SJ, Coiffier B. Report of an international workshop to standardize response criteria for non-Hodgkin’s lymphomas[J]. J Clin Oncol, 1999; 17: 1 244. [Erratum,] J Clin Oncol 2000; 18: 2 351.