CAJ | 학술논문

目的评价EPOCH方案治疗老年外周T细胞淋巴瘤( PTCL)患者的临床疗效和不良反应.方法对经病理确诊为PTCL老年患者28例,采用EPOCH方案治疗:依托泊苷50 mg/m2、表柔比星12mg/m2、长春新碱0.4mg/m2溶解于0.9%NaCl溶液持续静脉滴注,第1天至第4天;环磷酰胺750 mg/m2静脉滴注,第5天;泼尼松60 mg/m2口服,第1天至第5天,每21 d为1个疗程.依据WHO标准进行疗效和安全性分析和评估.结果 28例患者共完成85个疗程EPOCH方案化疗,中位化疗2个疗程,完全缓解(CR)15例,部分缓解(PR)5例,总有效(OR)率71.4%(20/28),总体平均生存时间20个月.初治患者CR率64.7%(11/17),PR率23.5%(4/17),OR率88.2%(15/17),明显高于诱导化疗失败的难治性患者[分别为36.4%(4/11)、9.1%(1/11)和45.5%(5/11)].两组OR率比较差异有统计学意义(λ2=5.99,P＜0.05),且初治患者平均生存时间长于难治性患者(24个月与13个月).EPOCH方案化疗的主要毒副作用为骨髓抑制,其中Ⅲ～Ⅳ度粒细胞和血小板减少的发生率分别为53.6%(15/28)和50.0%(14/28),非血液毒性发生率较低,初治与难治性患者的不良反应发生率差异无统计学意义(P＞0.05).结论 EPOCH方案是治疗老年PTCL患者有效而且耐受性较好的化疗方案.
목적 평개EPOCH방안치료노년외주T세포림파류( PTCL)환자적림상료효화불량반응.방법 대경병리학진위PTCL노년환자28례,채용EPOCH방안치료:의탁박감50 mg/m2、표유비성12mg/m2、장춘신감0.4mg/m2용해우0.9%NaCl용액지속정맥적주,제1천지제4천;배린선알750 mg/m2정맥적주,제5천;발니송60 mg/m2구복,제1천지제5천,매21 d위1개료정.의거WHO표준진행료효화안전성분석화평고.결과 28례환자공완성85개료정EPOCH방안화료,중위화료2개료정,완전완해(CR)15례,부분완해(PR)5례,총유효(OR)솔71.4%(20/28),총체평균생존시간20개월.초치환자CR솔64.7%(11/17),PR솔23.5%(4/17),OR솔88.2%(15/17),명현고우유도화료실패적난치성환자[분별위36.4%(4/11)、9.1%(1/11)화45.5%(5/11)].량조OR솔비교차이유통계학의의(λ2=5.99,P＜0.05),차초치환자평균생존시간장우난치성환자(24개월여13개월).EPOCH방안화료적주요독부작용위골수억제,기중Ⅲ～Ⅳ도립세포화혈소판감소적발생솔분별위53.6%(15/28)화50.0%(14/28),비혈액독성발생솔교저,초치여난치성환자적불량반응발생솔차이무통계학의의(P＞0.05).결론 EPOCH방안시치료노년PTCL환자유효이차내수성교호적화료방안.
Objective To evaluate the clinical efficacy and toxicity of EPOCH regimen in the treatment of elderly patients with peripheral T-cell lymphoma. Methods Twenty-eight elderly patients with pathologically diagnosed peripheral T-cell lymphoma were treated with EPOCH regimen, including 96-hour continuous infusion of etoposide 50 mg/m2, epirubincin 12 mg/m2 and vincristin 0.4 mg/m2 on daysl through 4,cyclophosphamide 750 mg/m2 given as intravenous bolus on day 5 and prednisone 60 mg/m2 administered orally on daysl through 5. The EPOCH regimen was repeated very 21 days. Clinical efficacy and safety profiles of EPOCH regimen was systemically reviewed and analysed. Results All the 28 patients received a total of 85 cycles of EPOCH regimen. The median cycles was two courses. Fifteen patients achieved complete response, while five cases obtaining partial response. The overall response rate was 71.4 %. The median survival time was 20 months. In newly diagnosed patients, complete response rate (CR) as well as partial response (PR) and overall response rate (OR) reached 64.7 %, 23.5 % and 88.2 %, respectively, which was significantly higher than that in refractory cases, whose CR, PR and OR were 36.4 %, 9.1% and 45.5 %(λ 2 = 5.99, P ＜0.05). In addition, the median survivalduration of newly diagnosed patients was longer than that of refractory cases, whose median survival time was 24 and 13 months, respectively. The major adverse events was myelosuppression with grade 3-4 neutropenia and thrombocytopenia in 53.6 % and 50.0 % cases.Non-hematologic toxicities were moderate and uncommon. The frequency of adverse effects in de novo patients showed little difference in comparison with that in refractory ones (P＞0.05). Conclusion EPOCH regimen was an effective and well tolerated therapeutic schedule for elderly patients with peripheral T-cell lymphoma.