摘要
目的:对比奥沙利铂联合吉西他滨(GOX)与DICE方案二线治疗复发性或难治性非霍奇金淋巴瘤(NHL)的疗效及毒副作用。方法:选取复发难治性非霍奇金淋巴瘤患者55例,随机分为两组,分别接受GOX方案和DICE方案化疗。GOX组方案为:GEM1000mg/m^2,静脉滴注,d1、d8,LOHP130mg/m^2,静脉滴注,d1;21d为1个周期。DICE组方案为:地塞米松(DXM)20mg,静脉滴注,d1～d4;异环磷酰胺(IFO)1g/m^2,静脉滴注,d1～d4;Mesna解救400mg,静脉滴注q8h,d1～d4;顺铂(DDP)25mg/m^2,静脉滴注,d1～d4;依托泊苷(Vp-16)100mg/m^2,静脉滴注,d1～d4。21～28d为1个周期。每2周进行疗效及毒性评价。结果:55例患者中,GOX方案组CR3例(11.5%),PR14例(53.8%),SD5例,PD4例,总有效率(CR+PR)为65.4%,临床获益率(CR+PR+SD)达到84.6%。DICE组CR4例(13.8%),PR12例(41.4%),SD8例,PD5例,总有效率55.2%,临床获益率82.7%。针对不同的细胞类型,GOX组中T细胞淋巴瘤患者总有效率为60.0%,B细胞淋巴瘤总有效率达68.8%,在DICE组T细胞淋巴瘤总有效率50.0%,而B细胞淋巴瘤为57.9%。两组的毒副反应主要为骨髓抑制,其中GOX组白细胞下降Ⅲ度7例,Ⅳ度2例;贫血Ⅲ度2例;血小板下降Ⅲ度5例,Ⅳ度2例。DICE组白细胞下降Ⅲ度12例,Ⅳ度4例;贫血Ⅲ度2例;血小板下降Ⅲ度3例,Ⅳ度1例。胃肠道反应较GOX组为重,Ⅲ度2例,Ⅳ度1例。比较两组毒副反应,GOX组在中性粒细胞减少,消化道反应方面明显好于DICE组(P<0.05)。而DICE组出现未出现末梢神经毒性病例。结论:GOX方案二线治疗复发或难治性非霍奇金淋巴瘤是较为安全且有效的化疗方案,其远期疗效尚需进一步观察。
Objective： To compare the efficacy and safety of GOX and DICE regimen for relapsed or refractory non-Hodgkin＇s lymphoma （NHL）. Methods： A total of 55 cases of relapsed and refractory NHL were randomly divided into two groups and received GOX and DICE treatment, respectively. The GOX regimen included GEM1000mg/m^2, ivd, dl, 8; L-OHP 130mg/m^2, ivd, dl; 21d per cycle. The DICE regimen included DXM 20mg, ivd, dl-d4; IFO lg/m^2, ivd, dl-4; Mesna 400mg, ivd q8h, dl-d4; DDP 25mg/m^2, ivd, dl-d4; Vp-16 100mg/m^2, ivd, dl-d4, 21-28d per cycle. The efficacy and safety were evaluated every two weeks. Results： In GOX group, there were 3 CR cases （11.5%）, 14 PR cases （53.8%）, 5 SD cases, and 5 PD cases. The total response rate （CR＋PR） was 65.4%, and the clinical benefit rate （CR＋PR＋ SD） was 84.6%. In DICE group, there were 4 CR cases （13.8%）, 12 PR cases （41.4%）, 8 SD cases, and 5 PD cases. The total response rate （CR＋PR） was 55.2%, and the clinical benefit rate （CR＋PR＋SD） was 82.7%. The main side effect was bone marrow suppression. In GOX group, there were 7 cases with leukopenia Ⅲ, 2 cases with leukopenia IV; 2 cases with anemia Ⅲ, 5 cases with thrombocytopenia Ⅲ, and 2 cases with thrombocytopenia Ⅳ. In DICE group, there were 12 cases with leukopenia Ⅲ, 3 cases with leukopenia Ⅳ, 2 cases with anemia Ⅲ, 3 cases with thrombocytopenia Ⅲ and 1 case with thrombocy- topenia Ⅳ. The gastrointestinal tract reaction was more serious in DICE group than in GOX group, with 2 cases of Ⅲ and 1 case of Ⅳ. Conclusion： GOX is a safer and more effective regimen for relapsed or refractory NHL, and its long-term effect needs to be further investigated.
出处
《中国肿瘤临床》
CAS
CSCD
北大核心
2010年第13期760-762,769,共4页
Chinese Journal of Clinical Oncology
