摘要
目的:为提高疗效,减少耐药、降低药物不良反应,寻找高效低毒的药物结构类似物进行化学治疗(化疗)方案组合治疗非霍奇金淋巴瘤(NHL)。方法:回顾性分析本科室15年来B细胞NHL患者101例,分成ITOD(异环磷酰胺、长春地辛、吡柔比星、地塞米松)及CHOP(环磷酰胺、长春新碱、多柔比星、泼尼松)序贯治疗组(序贯组)和单纯应用CHOP治疗组(对照组)2组。进行完全缓解(CR)率、部分缓解(PR)率、未缓解(NR)率、生存率(1、3、5年)的评估以及化疗不良反应的对照分析。结果:①序贯组的CR率、总反应率均高于对照组,PR率稍低于对照组,但没有显著意义(P>0.05);②对照组与序贯组的1年生存率分别是86.9%(20/23)和85.9%(67/78),3年生存率分别为65.2%(15/23)和71.8%(56/78),5年生存率分别为43.5%(10/23)和50.0%(39/78),序贯组略高于对照组,但统计学比较均无显著差异(P>0.05);经多元回归分析,发现临床分期、有无巨大肿块和治疗方案与治疗反应率呈相关关系(P<0.01);③101例患者共接受539个疗程化疗,肝肾毒性、骨髓抑制、胃肠道反应和脱发为主要不良反应。仅心脏毒性对照组高于序贯组(P<0.01)。结论:ITOD、CHOP序贯治疗是治疗B细胞恶性淋巴瘤有效且安全的化疗方案,其反应率、生存率与经典CHOP方案比较无明显差异,但其心脏不良反应明显低于传统CHOP方案。
Objective To compare the therapeutic response and safety of ITOD（ifosfamide,pirarubicin,vindesine,dexamethasone）/CHOP（cyclophophamide,doxorubicin vincristine,prednisone） regimen and CHOP regimen in the treatment of non-Hodgkin＇s lymphoma.Methods One hundred and one non-Hodgkin＇s lymphoma patients were enrolled in this study.Patients were divided into two groups.One group was treated with sequential ITOD/CHOP regimen and the other was treated with classic CHOP regimen（control group）.Complete remission（CR） rate,partial remission（PR） rate,no response（NR） rate,1-,3-,and 5-year survival rates and chemotherapy adverse effects were analyzed.Results CR rate and overall response rate in sequential ITOD/CHOP group were higher than that of CHOP control group;PR rate was slightly lower than that in CHOP control group（33.3% vs 34.8%,P0.05）.No statistical significant differences were seen between the 1-,3-,and 5-year survival rates in sequential ITOD/CHOP group（86.9%,65.2% and 43.5%,respectively） and in control group（85.9%,71.6% and 50%,respectively）.Multiple variance regression analysis showed that clinical stage and presence of big mass were correlated with therapeutic regimen and response rate（P0.01）.Altogether 539 courses of chemotherapy were afforded to 101 patients,liver and renal toxicity,myelosuppression,gastrointestinal adverse effects and alopecia were the dominant adverse effects.No significant differences in the occurrence of adverse effects were seen between the two groups except cadiotoxicity,which was significantly higher in control group（41.8% vs 24.9%,P0.01）.Conclusions Sequential ITOD/CHOP regimen is an effective and safe chemotherapy regimen for treating B cell malignant lymphoma,response rate and survival rate were not significantly different from the classic CHOP regimen,while its cardiotoxicity was significantly lower than that of classic CHOP regimen.
出处
《内科理论与实践》
2011年第1期48-51,共4页
Journal of Internal Medicine Concepts & Practice
关键词
恶性淋巴瘤
化学治疗
序贯治疗
Malignant lymphoma
Chemotherapy
Sequential therapy
