摘要
目的：探讨不同剂量硼替佐米的BDT（硼替佐米/地塞米松/沙利度胺）方案治疗新诊断多发性骨髓瘤的近期疗效及安全性。方法：将2011年6月-2014年6月本院收治的40例新诊断多发性骨髓瘤患者用随机数字表法分为小剂量组和标准剂量组,每组20例。所有患者均采用BDT方案化疗,标准剂量组分别于第1、4、8、11天给予硼替佐米1.3 mg/m2皮下注射,第1-2、4-5、8-9、11-12天给予地塞米松40 mg,静脉滴注,沙利度胺100 mg,每晚睡前顿服。小剂量组将硼替佐米的剂量减少至1.0 mg/m2,其余同标准剂量组。3周为一疗程,治疗时间2-4疗程。所有患者在治疗前及每个疗程结束后进行血常规、肝肾功能、电解质、免疫球蛋白、β2-微球蛋白、血尿免疫固定电泳等常规检查,观察患者临床疗效及不良反应发生情况并及时进行记录。结果：化疗2个疗程及4个疗程后,两组患者整体疗效、总反应率（ORR）和完全反应率（CRR）比较,差异无统计学意义（P〉0.05）,小剂量组完成4个化疗疗程的患者所占比例高于标准剂量组,但比较差异无统计学意义（P〉0.05）。小剂量组消化道反应、周围神经病变程度和血液系统毒性等不良反应发生率均低于标准剂量组,消化道反应、周围神经病变程度也较标准剂量组更轻微,但比较差异无统计学意义（P〉0.05）,且消化道反应程度、周围神经病变程度与硼替佐米剂量不存在明显的相关性（P〉0.05）。小剂量组严重消化道反应（3-4级）发生率低于标准剂量组,比较差异有统计学意义（P〈0.05）。结论：小剂量硼替佐米的BDT方案治疗新诊断多发性骨髓瘤近期疗效较为满意,同时一定程度上降低了消化道反应、周围神经病变及血液系统毒性等不良反应的发生率和严重程度,有利于提高治疗的依从性。
Objective：To investigate the recent curative effect and security of newly diagnosed multiple myeloma treating with BDT（Bortezomib combined with Dexamethasone and Thalidomide） scheme of different doses of Bortezomib.Method：Forty patients with newly diagnosed multiple myeloma in our hospital from June 2011 to June 2014 were divided into small dose group and standard dose group according to the random number table,20 patients in each group.All the patients were treated with BDT scheme,the standard dose group was given 1.0 mg/m2 Bortezomib through subcutaneous injection at d 1,4,8,11,40 mg Dexamethasone through intravenous drip at d 1-2,4-5,8-9,11-12 and 100 mg Thalidomide taken before bedtime for treatment.The small dose group was given the same therapy as the standard dose group except reducing the dosage of Bortezomib to 1.0 mg/m2.The treatment time was 2-4 courses,3 weeks for each course.All the patients got tests of blood routine examination,hepatic and renal function,immune globulin,β2-microglobulin and immunofixation electrophoresis of hematuresis before treatment and after each course of treatment.The clinical efficacy and adverse reactions of all patients were observed and recorded.Result：After 2 and 4 coursed of chemotherapy,the overall effect, overall response rate（ORR） and complete response rate（CRR） of the two groups had no statistically significant difference（P〈0.05）,the proportion of patients who completed four courses of chemotherapy of the small dose group was higher than that of the standard dose group,but the difference was not statistically significant（P〈0.05）.The adverse reactions incidence of digestive tract reaction,peripheral neuropathy and blood system toxicity of the small dose group were lower than those of the standard dose group,and the degree of digestive tract reaction and peripheral neuropathy were more mild,but the differences were not statistically significant（P〈0.05）,and there was no obvious correlation between the digestive tract reaction,periph
出处
《中国医学创新》
CAS
2016年第7期7-11,共5页
Medical Innovation of China
