晚期弥漫性大 B 细胞淋巴瘤 (DLBCL) 的一线治疗通常涉及 6x R-CHOP21 或 6x R-CHOP21 加上两次额外的利妥昔单抗给药 (6x R-CHOP21  2 R)。在当代实践中，这种治疗选择可能会受到中期 PET 扫描结果的指导。这项全国性的、以人群为基础的研究调查了在 PET 引导的临时治疗决策尚未成为标准做法的时代，这些治疗方案的比较有效性。利用荷兰癌症登记处，我们确定了 2014 年至 2018 年间诊断为晚期 DLBCL 的 1577 名成年患者，他们完成了 6 次 R-CHOP21 (43%) 或 6 次 R-CHOP21   2 R (57%)。我们使用倾向评分来评估无事件生存期 (EFS) 和总生存期 (OS) 的差异。五年时，EFS（6x R-CHOP21   2 R 与 6x R-CHOP21 的风险比 [HR] = 0.89；95% 置信区间 [CI]，0.72-1.09）和 OS（HR = 0.93；95% CI，0.73） -1.18）两种方案之间没有显着差异。在根据国际预后指数 (IPI) 进行的探索性风险分层分析中，高 IPI 患者（即评分为 4-5）从 6x R-CHOP21  2 R 中受益最多（EFS 的 5 年绝对风险差 = 16.8%） ；95% CI，-0.4%-34.1%，OS = 12.1%；95% CI，-5.4-29.6%）。总的来说，该分析显示两种治疗之间的平均 EFS 和 OS 没有显着差异。然而，接受 6x R-CHOP21  2 R 治疗的高危患者的潜在益处强调了未来研究的必要性。© 2024。作者。

First-line treatment for advanced-stage diffuse large B-cell lymphoma (DLBCL) typically involves 6x R-CHOP21 or 6x R-CHOP21 with two additional rituximab administrations (6x R-CHOP21 + 2 R). In contemporary practice, this treatment choice might be guided by interim PET scan results. This nationwide, population-based study investigates the comparative effectiveness of these treatment regimens in an era where interim PET-guided treatment decisions were not standard practice. Utilizing the Netherlands Cancer Registry, we identified 1577 adult patients diagnosed with advanced-stage DLBCL between 2014-2018 who completed either 6x R-CHOP21 (43%) or 6x R-CHOP21 + 2 R (57%). We used propensity scores to assess differences in event-free survival (EFS) and overall survival (OS). At five years, EFS (hazard ratio of 6x R-CHOP21 + 2 R versus 6x R-CHOP21 [HR] = 0.89; 95% confidence interval [CI], 0.72-1.09) and OS (HR = 0.93; 95% CI, 0.73-1.18) were not significantly different between both regimens. In exploratory risk-stratified analysis according to the International Prognostic Index (IPI), high-IPI patients (i.e., scores of 4-5) benefit most from 6x R-CHOP21 + 2 R (5-year absolute risk difference of EFS = 16.8%; 95% CI, -0.4%-34.1% and OS = 12.1%; 95% CI, -5.4-29.6%). Collectively, this analysis reveals no significant differences on average in EFS and OS between the two treatments. However, the potential benefits for high-risk patients treated with 6x R-CHOP21 + 2 R underscore the need for future research.© 2024. The Author(s).