Abstract：
BACKGROUND: The management of diffuse large B-cell lymphoma (DLBCL) in elderly patients is complicated by an increased risk of treatment-related toxicity associated with aging. This study aimed to validate the effectiveness of the Cancer Aging and Research Group (CARG) model in elderly patients with DLBCL receiving rituximab-based chemotherapy.
METHODS: In this prospective study, elderly DLBCL patients (aged 65 years or older) receiving rituximab-based chemotherapy were consecutively assessed between August 2016 and December 2021 at one medical center in Taiwan using the CARG model to predict treatment-related toxicity. Patients were categorized into low-, medium-, and high-risk groups based on their CARG scores. Comparisons were made regarding toxicities and survival rates among these groups.
RESULTS: Ninety-one patients, with a median age of 70 years (range 65-96), were included. A substantial 81 % (74 patients) experienced grade 3-5 toxicity. The overall 2-year survival rate was 63.8 % after a median follow-up of 28 months (range, 2-46). The risk of grade 3-5 toxicity was 83 %, 78 %, and 87 %, respectively, among the low-, medium-, and high-risk groups (p = 0.60). The receiver operating characteristic (ROC) curve for CARG was 0.521 (95 % CI, 0.376-0.666), which was significantly lower than that for the Eastern Cancer Oncology Group score (ROC = 0.701, 95 % CI, 0.571-0.831). Similarly, compared with those of low-risk patients, hazard ratios for overall survival were 9.22 (95 % CI, 1.23-69.1; p = 0.031) and 14.6 (95 % CI, 1.90-112; p = 0.010) for medium- and high-risk patients, respectively.
CONCLUSIONS: While CARG exhibited limitations in predicting treatment-related toxicity in elderly DLBCL patients, it demonstrated potential efficacy in predicting survival outcomes.
METHODS: In this prospective study, elderly DLBCL patients (aged 65 years or older) receiving rituximab-based chemotherapy were consecutively assessed between August 2016 and December 2021 at one medical center in Taiwan using the CARG model to predict treatment-related toxicity. Patients were categorized into low-, medium-, and high-risk groups based on their CARG scores. Comparisons were made regarding toxicities and survival rates among these groups.
RESULTS: Ninety-one patients, with a median age of 70 years (range 65-96), were included. A substantial 81 % (74 patients) experienced grade 3-5 toxicity. The overall 2-year survival rate was 63.8 % after a median follow-up of 28 months (range, 2-46). The risk of grade 3-5 toxicity was 83 %, 78 %, and 87 %, respectively, among the low-, medium-, and high-risk groups (p = 0.60). The receiver operating characteristic (ROC) curve for CARG was 0.521 (95 % CI, 0.376-0.666), which was significantly lower than that for the Eastern Cancer Oncology Group score (ROC = 0.701, 95 % CI, 0.571-0.831). Similarly, compared with those of low-risk patients, hazard ratios for overall survival were 9.22 (95 % CI, 1.23-69.1; p = 0.031) and 14.6 (95 % CI, 1.90-112; p = 0.010) for medium- and high-risk patients, respectively.
CONCLUSIONS: While CARG exhibited limitations in predicting treatment-related toxicity in elderly DLBCL patients, it demonstrated potential efficacy in predicting survival outcomes.
摘要：
背景：老年患者弥漫性大B细胞淋巴瘤（DLBCL）的治疗因与衰老相关的治疗相关毒性风险增加而复杂化。本研究旨在验证癌症衰老和研究组（CARG）模型在接受基于利妥昔单抗的化疗的老年DLBCL患者中的有效性。
方法：在这项前瞻性研究中，2016年8月至2021年12月期间,在台湾一家医疗中心使用CARG模型对接受以利妥昔单抗为基础的化疗的老年DLBCL患者(年龄65岁或以上)进行了连续评估,以预测治疗相关毒性.患者被分类为低，medium-,和高危人群的CARG评分。比较了这些组之间的毒性和生存率。
结果：91名患者，年龄中位数为70岁（65-96岁），包括在内。大量81%(74名患者)经历3-5级毒性。中位随访28个月后，2年总生存率为63.8%（范围，2-46).3-5级毒性的风险为83%,78%,87%,分别,在低收入人群中，medium-,和高危人群(p=0.60)。CARG的受试者工作特征（ROC）曲线为0.521（95％CI，0.376-0.666），显著低于东部癌症肿瘤组评分(ROC=0.701,95%CI,0.571-0.831)。同样，与低风险患者相比，中高危患者的总生存率风险比分别为9.22(95%CI,1.23-69.1;p=0.031)和14.6(95%CI,1.90-112;p=0.010),分别。
结论：虽然CARG在预测老年DLBCL患者治疗相关毒性方面表现出局限性，它显示了在预测生存结局方面的潜在功效.
方法：在这项前瞻性研究中，2016年8月至2021年12月期间,在台湾一家医疗中心使用CARG模型对接受以利妥昔单抗为基础的化疗的老年DLBCL患者(年龄65岁或以上)进行了连续评估,以预测治疗相关毒性.患者被分类为低，medium-,和高危人群的CARG评分。比较了这些组之间的毒性和生存率。
结果：91名患者，年龄中位数为70岁（65-96岁），包括在内。大量81%(74名患者)经历3-5级毒性。中位随访28个月后，2年总生存率为63.8%（范围，2-46).3-5级毒性的风险为83%,78%,87%,分别,在低收入人群中，medium-,和高危人群(p=0.60)。CARG的受试者工作特征（ROC）曲线为0.521（95％CI，0.376-0.666），显著低于东部癌症肿瘤组评分(ROC=0.701,95%CI,0.571-0.831)。同样，与低风险患者相比，中高危患者的总生存率风险比分别为9.22(95%CI,1.23-69.1;p=0.031)和14.6(95%CI,1.90-112;p=0.010),分别。
结论：虽然CARG在预测老年DLBCL患者治疗相关毒性方面表现出局限性，它显示了在预测生存结局方面的潜在功效.
