现代肿瘤医学
現代腫瘤醫學
현대종류의학
JOURNAL OF MODERN ONCOLOGY
2014年
6期
1438-1440
,共3页
徐小红%杨磊%谭清和%丛智荣%倪静怡%吴德祥
徐小紅%楊磊%譚清和%叢智榮%倪靜怡%吳德祥
서소홍%양뢰%담청화%총지영%예정이%오덕상
结外NK/T细胞淋巴瘤%鼻型%化疗%左旋门冬酰胺酶%培门冬酶
結外NK/T細胞淋巴瘤%鼻型%化療%左鏇門鼕酰胺酶%培門鼕酶
결외NK/T세포림파류%비형%화료%좌선문동선알매%배문동매
extranodal NK/T-cell lymphoma%nasal type%chemotherapy%L-Asparaginase%pegasparagase
目的:观察改良SMILE方案治疗结外NK/T细胞淋巴瘤的近期疗效和安全性。方法:2009年6月至2012年3月收治的7例Ⅲ-Ⅳ期患者,3例为初治,4例为复发、难治性患者,均采用改良SMLIE(甲基强的松龙80mg,iv,d2-5;异环磷酰胺( IFO)1.333g/m2,iv,d2-5,美司钠( Mesna)300mg/m2,iv,给药0、4、8h,依托泊苷(Vp-16)75mg/m2,iv,d2-5;培门冬酶(Pegasparaginase)2500IU/m2,im,d1;甲氨蝶呤(MTX)1.0g/m2,iv,6h, d5)方案化疗。结果:7例患者共接受SMILE方案化疗31周期,每例至少2个周期,其中,CR 5例,PR 1例,PD 1例,近期总有效率为85.7%,CR率为71.4%。其中,11周期出现Ⅲ﹢Ⅳ度白细胞减少,3周期出现Ⅲ﹢Ⅳ度血红蛋白下降,6周期出现Ⅲ﹢Ⅳ度血小板减少,4周期出现Ⅲ度肝功能损害,对症处理后恢复。结论:改良SMILE方案治疗初治或难治性NK/T细胞淋巴瘤疗效较好,毒性可以耐受,值得临床进一步探讨。
目的:觀察改良SMILE方案治療結外NK/T細胞淋巴瘤的近期療效和安全性。方法:2009年6月至2012年3月收治的7例Ⅲ-Ⅳ期患者,3例為初治,4例為複髮、難治性患者,均採用改良SMLIE(甲基彊的鬆龍80mg,iv,d2-5;異環燐酰胺( IFO)1.333g/m2,iv,d2-5,美司鈉( Mesna)300mg/m2,iv,給藥0、4、8h,依託泊苷(Vp-16)75mg/m2,iv,d2-5;培門鼕酶(Pegasparaginase)2500IU/m2,im,d1;甲氨蝶呤(MTX)1.0g/m2,iv,6h, d5)方案化療。結果:7例患者共接受SMILE方案化療31週期,每例至少2箇週期,其中,CR 5例,PR 1例,PD 1例,近期總有效率為85.7%,CR率為71.4%。其中,11週期齣現Ⅲ﹢Ⅳ度白細胞減少,3週期齣現Ⅲ﹢Ⅳ度血紅蛋白下降,6週期齣現Ⅲ﹢Ⅳ度血小闆減少,4週期齣現Ⅲ度肝功能損害,對癥處理後恢複。結論:改良SMILE方案治療初治或難治性NK/T細胞淋巴瘤療效較好,毒性可以耐受,值得臨床進一步探討。
목적:관찰개량SMILE방안치료결외NK/T세포림파류적근기료효화안전성。방법:2009년6월지2012년3월수치적7례Ⅲ-Ⅳ기환자,3례위초치,4례위복발、난치성환자,균채용개량SMLIE(갑기강적송룡80mg,iv,d2-5;이배린선알( IFO)1.333g/m2,iv,d2-5,미사납( Mesna)300mg/m2,iv,급약0、4、8h,의탁박감(Vp-16)75mg/m2,iv,d2-5;배문동매(Pegasparaginase)2500IU/m2,im,d1;갑안접령(MTX)1.0g/m2,iv,6h, d5)방안화료。결과:7례환자공접수SMILE방안화료31주기,매례지소2개주기,기중,CR 5례,PR 1례,PD 1례,근기총유효솔위85.7%,CR솔위71.4%。기중,11주기출현Ⅲ﹢Ⅳ도백세포감소,3주기출현Ⅲ﹢Ⅳ도혈홍단백하강,6주기출현Ⅲ﹢Ⅳ도혈소판감소,4주기출현Ⅲ도간공능손해,대증처리후회복。결론:개량SMILE방안치료초치혹난치성NK/T세포림파류료효교호,독성가이내수,치득림상진일보탐토。
Objective:To discuss the short-term efficacy and adverse effects of modified SMILE regimen in the treatment of nasal type extranodal NK/T-cell lymphoma. Methods:From June 2009 to March 2012,7 patients with stage Ⅲ and stageⅣENKTL-NT were involved in this study. Among them,4 patients were refractory and 3 patients were newly diagnosed. All patients were treated with modified SMILE protocol(Methylprednisolone 80mg,iv,d2-5;If-osfamide(IFO)1.333g/m2,iv,d2-5,the United States department of sodium(Mesna)300mg/m2,iv,drug 0,4 and 8h,etoposide(Vp-16)75mg/m2,iv,d2-5;Culture door winter enzyme(Pegasparaginase)2500IU/m2,im,d1;Meth-otrexate(MTX)1. 0g/m2,iv,6h). Results:All 7 patients received a total of SMILE regimen for 31 cycles. each case at least two cycles,Among the 7 patients,5 patients achieved complete remission,1 patient achieved partial remission and 1 patient was progressing. The overall response was 85. 7%,complete response rate was 71. 4%. Among them, grade Ⅲ-Ⅳ leucopenia was observed in 11 cycles,grade Ⅲ-Ⅳ hemoglobin decreased was observed in 3 cycles, gradeⅢ-Ⅳ thrombocytopenia was observed in 6 cycles,grade Ⅲ liver dysfunction was observed in 4 cycles. Con-clusion:Modified SMILE regimen is an effective treatment regimen for newly diagnosed,refractory patients with ENK-TL-NT.