个体化及缓和医疗用于90岁胃原发弥漫性大B细胞淋巴瘤患者：4年随访结果及启示

曹艳杰; 段景琪; 刘丽芳; 魏璇; 任力; 张蓝宁; 张伟

doi:10.24920/003682

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个体化及缓和医疗用于90岁胃原发弥漫性大B细胞淋巴瘤患者：4年随访结果及启示

中国医学科学杂志（英文版） 2021年36卷第1期页码：72-77

病例报告 | Updated：2024-04-10

- 个体化及缓和医疗用于90岁胃原发弥漫性大B细胞淋巴瘤患者：4年随访结果及启示
- Affiliations：
  
  1. 1Department of Geriatrics,Air Force Medical Center, Beijing 100142, China
  2. 2Department of Pathology, Air Force Medical Center, Beijing 100142, China
- Author bio：
  
  * Jingqi Duan, E-mail: 18610089727@163.com
- Funds：
  
  Funded by the Millitary Logistical Special Project for Health Care;军委后勤保障部保健专项课题(18BJZ07)
- DOI：10.24920/003682
  中图分类号：
- 收稿日期：2019-11-12，
  
  录用日期：2020-5-21，
  
  网络出版日期：2021-03-31，
  
  纸质出版日期：2021-03-31
- Accepted：
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曹艳杰, 段景琪, 刘丽芳, 等. 个体化及缓和医疗用于90岁胃原发弥漫性大B细胞淋巴瘤患者：4年随访结果及启示[J]. 中国医学科学杂志（英文版）, 2021,36(1):72-77.

Cao Yanjie, Duan Jingqi, Liu Lifang, et al. Individualized Treatment and Palliative Care for A 90-Year-Old Patient with Primary Gastric Diffuse Large-B Cell Lymphoma: 4 Year Follow-up and Inspiration[J]. Chinese medical sciences journal, 2021, 36(1): 72-77.
曹艳杰, 段景琪, 刘丽芳, 等. 个体化及缓和医疗用于90岁胃原发弥漫性大B细胞淋巴瘤患者：4年随访结果及启示[J]. 中国医学科学杂志（英文版）, 2021,36(1):72-77. DOI： 10.24920/003682.

Cao Yanjie, Duan Jingqi, Liu Lifang, et al. Individualized Treatment and Palliative Care for A 90-Year-Old Patient with Primary Gastric Diffuse Large-B Cell Lymphoma: 4 Year Follow-up and Inspiration[J]. Chinese medical sciences journal, 2021, 36(1): 72-77. DOI： 10.24920/003682.

摘要

本文报道一名90岁患者于2016年4月年度例行体检时

通过PET/CT、胃镜和病理+免疫组化确诊胃原发性弥漫性大B细胞淋巴瘤。患者接受了利妥昔单抗、环磷酰胺、长春新碱（R-CO）化疗以及后续的放疗。之后患者发生幽门梗阻

遂放置三腔鼻-胃肠管给予肠内营养。为了满足患者经口进食的强烈愿望

我们进行了剖腹探查和胃-空肠吻合术（RGB）以解除幽门梗阻。术后患者恢复了经口进食

并辅以鼻饲饮食

每日热量1350-1550 Kcal。患者目前94岁

营养状态中等

认知正常。本例4年诊疗及随访结果提示

除了有效的化疗、放疗以及外科手术治疗之外

营养照护和缓和医疗对改善超高龄晚期肿瘤患者的预后及生活质量也非常重要。

Abstract

A 90-year-old man was diagnosed with primary gastric diffuse large B-cell lymphoma (PGDLBL) by PET/CT examination

gastroscopy

biopsy and histopathological analysis at a regular physical check in April

2016. The patient received R-CO chemotherapy (rituximab

cyclophosphamide

and vincristine) and radiotherapy subsequently

with enteral nutritional treatment through 3-cavity nasogastric tube due to development of pyloric obstruction. To satisfy patient’s strong desire of eating by himself

we performed surgery of exploratory laparotomy and Roux-en-Y gastric bypass (RGB) to relieve pylorus obstruction. Postoperatively

the patient resumed oral feeding

supplemented by nasogastric tube feeding at 1350 - 1550 Kcal daily. He is now 94 years old with fairly well nutrition and normal communication. The outcome of 4 year follow-up suggests that nutritional treatment and palliative medicine are important for improving prognosis and life-quality of very elderly patients with end-stage tumors apart from the effective chemotherapy

radiotherapy

and surgery.

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Keywords

references

Koch P , del Valle F , Berdel WE , et al . Primary gastrointestinal non-Hodgkin’s lymphoma: I. Anatomic and histologic distribution, clinical features, and survival data of 371 patients registered in the German Multicenter Study GITNHL 01/92 . J Clin Oncol 2001 ; 19 ( 18 ): 3874 - 83 . doi: 10.1200/JCO.2001.19.18.3874 1001-9294-36-1-72/JCO.2001.19.18.3874 . DOI: 10.1200/JCO.2001.19.18.3874 http://doi.org/10.1200/JCO.2001.19.18.3874 https://www.ncbi.nlm.nih.gov/pubmed/11559725 https://www.ncbi.nlm.nih.gov/pubmed/11559725

Yang QP , Zhang WY , Yu JB , et al . Subtype distribution of lymphomas in Southwest China: Analysis of 6,382 cases using WHO classiﬁcation in a single institution . Diagn Pathol 2011 ; 6 : 77 . doi: 10.1186/1746-1596-6-77 1001-9294-36-1-72/1746-1596-6-77 . DOI: 10.1186/1746-1596-6-77 http://doi.org/10.1186/1746-1596-6-77 https://www.ncbi.nlm.nih.gov/pubmed/21854649 https://www.ncbi.nlm.nih.gov/pubmed/21854649

Sohn BS , Kim SM , Yoon DH , et al . The comparison between CHOP and R-CHOP in primary gastric diffuse large B cell lymphoma . Ann Hematol 2012 ; 91 : 1731 - 9 . doi: 10.1007/s00277-012-1512-4 1001-9294-36-1-72/s00277-012-1512-4 . DOI: 10.1007/s00277-012-1512-4 http://doi.org/10.1007/s00277-012-1512-4 https://www.ncbi.nlm.nih.gov/pubmed/22752193 https://www.ncbi.nlm.nih.gov/pubmed/22752193

Naruhiko I , Brian DB , Paul FM . Multimodality treatment of gastric lymphoma . Surg Clin N Am 2017 ; 97 ( 2 ): 405 - 20 . doi: 10.1016/j.suc.2016.11.012 1001-9294-36-1-72/j.suc.2016.11.012 . DOI: 10.1016/j.suc.2016.11.012 http://doi.org/10.1016/j.suc.2016.11.012 https://www.ncbi.nlm.nih.gov/pubmed/28325194 https://www.ncbi.nlm.nih.gov/pubmed/28325194

Peyrade F , Jardin F , Thieblemont C , et al . Attenuated immunochemotherapy regimen (R-mini CHOP) in elderly patients older than 80 years with diffuse large B-cell lymphoma: a multicentre, single-arm, phase 2 trial . Lancet Oncol 2011 ; 12 ( 5 ): 460 - 8 . doi: 10.1016/S1470-2045(11)70069-9 1001-9294-36-1-72/S1470-2045(11)70069-9 . DOI: 10.1016/S1470-2045(11)70069-9 http://doi.org/10.1016/S1470-2045(11)70069-9 https://www.ncbi.nlm.nih.gov/pubmed/21482186 https://www.ncbi.nlm.nih.gov/pubmed/21482186

Miyata Y , Saito AM , Yano T , et al . R-mini CHP in ≥ 80-year-old patients with diffuse large B-cell lymphoma: a multicenter, open-label, single-arm phase II trial protocol . Acta Med Okayama 2018 ; 72 ( 3 ): 315 - 8 . doi: 10.18926/AMO/56079 1001-9294-36-1-72/AMO/56079 . DOI: 10.18926/AMO/56079 http://doi.org/10.18926/AMO/56079 https://www.ncbi.nlm.nih.gov/pubmed/29926011 https://www.ncbi.nlm.nih.gov/pubmed/29926011

Rohatiner A , d’Amore F , Coiffier B , et al . Report on a workshop convened to discuss the pathological and staging classifications of gastrointestinal tract lymphoma . Ann Oncol 1994 ; 5 ( 5 ): 397 - 400 . doi: 10.1093/oxfordjournals.annonc.a058869 1001-9294-36-1-72/oxfordjournals.annonc.a058869 . DOI: 10.1093/oxfordjournals.annonc.a058869 http://doi.org/10.1093/oxfordjournals.annonc.a058869 https://www.ncbi.nlm.nih.gov/pubmed/8075046 https://www.ncbi.nlm.nih.gov/pubmed/8075046

Shipp MA , Harrington DP , Anderson JR , et al . A predictive model for aggressive non-Hodgkin lymphoma . N Engl J Med 1993 ; 329 ( 14 ): 987 - 94 . doi: 10.1056/NEJM199309303291402 1001-9294-36-1-72/NEJM199309303291402 . DOI: 10.1056/NEJM199309303291402 http://doi.org/10.1056/NEJM199309303291402 https://www.ncbi.nlm.nih.gov/pubmed/8141877 https://www.ncbi.nlm.nih.gov/pubmed/8141877

Thieblemont C , Coiffier B . Lymphoma in older patients . J Clin Oncol 2007 ; 25 ( 14 ): 1916 - 23 . doi: 10.1200/JCO.2006.10.5957 1001-9294-36-1-72/JCO.2006.10.5957 . DOI: 10.1200/JCO.2006.10.5957 http://doi.org/10.1200/JCO.2006.10.5957 https://www.ncbi.nlm.nih.gov/pubmed/17488991 https://www.ncbi.nlm.nih.gov/pubmed/17488991

Corazzelli G , Frigeri F , Arcamone M , et al . Biweekly rituximab, cyclophosphamide, vincristine, nonpegylated liposome-encapsulated doxorubicin and prednisone(R-COMP-14) in elderly patients with poor-risk diffuse large B-cell lymphoma and moderate to high ‘life threat’ impact cardiopathy . Br J Haematol 2011 ; 154 ( 5 ): 579 - 89 . doi: 10.1111/j.1365-2141.2011.08786.x 1001-9294-36-1-72/j.1365-2141.2011.08786.x . https://www.ncbi.nlm.nih.gov/pubmed/21707585 https://www.ncbi.nlm.nih.gov/pubmed/21707585

Vitolo U , Seymour JF , Martelli M , et al . Extranodal diffuse large B-cell lymphoma (DLBCL) and primary mediastinal B-cell lymphoma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up . Ann Oncol 2016 ; 27 ( Suppl 5 ): v91 - 102 . doi: 10.1093/annonc/mdw175 1001-9294-36-1-72/annonc/mdw175 . DOI: 10.1093/annonc/mdw175 http://doi.org/10.1093/annonc/mdw175 https://www.ncbi.nlm.nih.gov/pubmed/27377716 https://www.ncbi.nlm.nih.gov/pubmed/27377716

Held G , Murawski N , Ziepert M , et al . Role of radiotherapy to bulky disease in elderly patients with aggressive B-cell lymphoma . J Clin Oncol 2014 ; 32 : 1112 - 8 . doi: 10.1200/JCO.2013.51.4505 1001-9294-36-1-72/JCO.2013.51.4505 . DOI: 10.1200/JCO.2013.51.4505 http://doi.org/10.1200/JCO.2013.51.4505 https://www.ncbi.nlm.nih.gov/pubmed/24493716 https://www.ncbi.nlm.nih.gov/pubmed/24493716

Vargo JA , Gill BS , Balasubramani GK , et al . Treatment selection and survival outcomes in early-stage diffuse large B-cell lymphoma: do we still need consolidative radiotherapy? J Clin Oncol 2015 ; 33 ( 32 ): 3710 - 7 . doi: 10.1200/JCO.2015.61.7654 1001-9294-36-1-72/JCO.2015.61.7654 . DOI: 10.1200/JCO.2015.61.7654 http://doi.org/10.1200/JCO.2015.61.7654 https://www.ncbi.nlm.nih.gov/pubmed/26261253 https://www.ncbi.nlm.nih.gov/pubmed/26261253

Liu X , Fang H , Tian Y , et al . Intensity modulated radiation therapy for early-stage primary gastric diffuse large B-cell lymphoma: dosimetric analysis, clinical outcome, and quality of life . Int J Radiation Oncol Biol Phys 2016 ; 95 ( 2 ): 712 - 20 . doi: 10.1016/j.ijrobp.2016.01.027 1001-9294-36-1-72/j.ijrobp.2016.01.027 .

Qu X , Jiang N , Ge N , et al . Physicians perception of palliative care consultation service in a major general hospital in China . Chin Med Sci J 2018 ; 33 ( 4 ): 228 - 33 . doi: 10.24920/003515 1001-9294-36-1-72/003515 . DOI: 10.24920/003515 http://doi.org/10.24920/003515 https://www.ncbi.nlm.nih.gov/pubmed/30646986 https://www.ncbi.nlm.nih.gov/pubmed/30646986

Xiang Y , Ning X . Recognition of palliative care in Chinese clinicians: How they feel and what they know . Chin Med Sci J 2018 ; 33 ( 4 ): 221 - 7 . doi: 10.24920/003509 1001-9294-36-1-72/003509 . DOI: 10.24920/003509 http://doi.org/10.24920/003509 https://www.ncbi.nlm.nih.gov/pubmed/30646985 https://www.ncbi.nlm.nih.gov/pubmed/30646985

Fulton JJ , Newins AR , Porter LS , et al . Psychotherapy targeting depression and anxiety for use in palliative care: a meta-analysis . J Palliat Med 2018 ; 21 ( 7 ): 1024 - 37 . doi: 10.1089/jpm.2017.0576 1001-9294-36-1-72/jpm.2017.0576 . DOI: 10.1089/jpm.2017.0576 http://doi.org/10.1089/jpm.2017.0576 https://www.ncbi.nlm.nih.gov/pubmed/29676960 https://www.ncbi.nlm.nih.gov/pubmed/29676960

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