摘要
目的 探讨血管生成拮抗剂辅助改良CHOP方案治疗Ⅲ~Ⅳ期复发难治性非霍奇金淋巴瘤（NHL）的疗效及安全性.方法 选取Ⅲ~Ⅳ期复发难治性NHL患者共140例,以随机数字表法分为对照组和观察组,每组70例,分别给予改良CHOP方案单用和在此基础上加用沙利度胺辅助治疗,比较两组患者近期疗效,随访1、2、3年生存率,治疗前后乳酸脱氢酶、血管内皮细胞生长因子水平及严重不良反应发生率等.结果 观察组治疗总有效率显著高于对照组（P〈0.05）;观察组随访1、2、3年生存率均显著高于对照组（P均〈0.05）;观察组治疗后乳酸脱氢酶和血管内皮细胞生长因子水平均显著低于对照组及其治疗前（P均〈0.05）;两组Ⅲ~Ⅳ度白细胞下降、血红蛋白下降、血小板减少、脱发及心脏毒性发生率比较差异未见统计学意义（P〉0.05）.结论 血管生成拮抗剂辅助改良CHOP方案治疗Ⅲ~Ⅳ期复发难治性NHL可有效控制疾病进展,延长生存时间,且安全性符合临床需要;下调乳酸脱氢酶和血管内皮细胞生长因子水平可能是联合治疗方案具有更佳疗效的重要机制.
Objective To investigate the clinical effects and safety of angiogenesis antagonists assisted with modified CHOP regimen on recurrent and refractory NHL for Ⅲ-Ⅳ stage.Methods One hundred and forty patients with recurrent and refractory NHL for Ⅲ-Ⅳ stage were chosen and randomly divided into two groups, control group （70 patients） with modified CHOP regimen used alone and observation group （70 patients） with thalidomide on the basis of control group.The clinical efficacy for short-term, the survival rates in 1, 2 and 3 years of follow-up, the levels of sVEGF and LDH before and after treatment and the incidences of serious toxic side effects of the two groups were compared.Results The clinical total efficacy of observation group was significant better than that of control group（P〈0.05）.The survival rates in 1, 2 and 3 years with follow-up of observation group were significant higher than those of the control group（P〈0.05）.The levels of LDH and sVEGF after treatment of observation group were significant lower than those of control group and before treatment（P〈0.05）.There was no significant difference in the serious toxic side effects incidence between the two groups（P〉0.05）.Conclusions Angiogenesis antagonists assisted with modified CHOP regimen in treatment of recurrent and refractory NHL for Ⅲ-Ⅳ stage can efficiently control the disease progression, prolong the survival time, improve the long-term survival rate, and its safety compliance with clinical needs.The reduction of LDH and VEGF levels may be the important mechanism of combination therapy with better clinical efficacy.
出处
《中国实用医刊》
2017年第9期4-6,共3页
Chinese Journal of Practical Medicine
关键词
化疗
沙利度胺
复发难治
非霍奇金淋巴瘤
疗效
安全性
Chemotherapy
Thalidomide
Recurrent and refractory
Non-Hodgkin＇s lymphoma
Clinical effects
Safety
