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变得复杂。本研究旨在验证癌症老龄化和研究小组 (CARG) 模型对接受基于利妥昔单抗的化疗的老年 DLBCL 患者的有效性。在这项前瞻性研究中，接受基于利妥昔单抗的化疗的老年 DLBCL 患者（年龄 65 岁或以上） 2016 年 8 月至 2021 年 12 月在台湾一家医疗中心使用 CARG 模型连续评估，以预测治疗相关毒性。根据 CARG 评分，患者被分为低、中、高风险组。对这些组之间的毒性和生存率进行了比较。纳入了 91 名患者，中位年龄为 70 岁（范围为 65-96 岁）。 81%（74 名患者）经历了 3-5 级毒性。中位随访 28 个月（范围 2-46）后，总体 2 年生存率为 63.8%。低、中、高风险组中 3-5 级毒性的风险分别为 83%、78% 和 87% (p = 0.60)。 CARG 的受试者工作特征 (ROC) 曲线为 0.521（95% CI，0.376-0.666），显着低于东部癌症肿瘤学组评分（ROC = 0.701，95% CI，0.571-0.831）。同样，与低危患者相比，中危和危重患者的总生存风险比分别为 9.22（95% CI，1.23-69.1；p = 0.031）和 14.6（95% CI，1.90-112；p = 0.010）。虽然 CARG 在预测老年 DLBCL 患者的治疗相关毒性方面表现出局限性，但它在预测生存结果方面表现出了潜在的功效。版权所有 © 2024 Elsevier B.V. 保留所有权利。

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.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.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.While CARG exhibited limitations in predicting treatment-related toxicity in elderly DLBCL patients, it demonstrated potential efficacy in predicting survival outcomes.Copyright © 2024 Elsevier B.V. All rights reserved.