CAJ | 학술논문

目的评价占西他滨联合奥沙利铂(GEMOX)方案在多种化疗方案治疗失败后淋巴瘤患者中的疗效和安全性.方法回顾性分析经2种或2种以上的化疗方案治疗失败后、采用GEMOX方案进行解救化疗的27例淋巴瘤患者,探讨其与临床疗效相关的预测指标.结果 24例患者可评价近期疗效,其中完全缓解(CR)4例(16.7％),部分缓解(PR)7例(29.1％),稳定(SD)6例(25.0％),进展(PD)7例(29.1％),总缓解率为45.8％.在获得CR和PR的11例患者中,弥漫大B细胞淋巴瘤4例,霍奇金淋巴瘤4例,外周T细胞淋巴瘤1例,套细胞淋巴瘤1例,胃黏膜相关淋巴组织淋巴瘤1例.全组患者的中位无进展生存时间(PFS)为8个月(95％ CI为1.6～14.4个月),11例获得CR和PR患者的中位PFS为19个月(95％ CI为11.1～26.8个月).不良反应主要为骨髓抑制,其中出现Ⅲ～Ⅳ度中性粒细胞减少16例(59.3％),出现Ⅲ～Ⅳ度血小板减少11例(40.7％).前次化疗方案的敏感性与GEMOX方案的缓解率相关,前次化疗敏感患者的GEMOX方案缓解率为83.3％,前次化疗不敏感患者的缓解率为31.2％,差异有统计学意义(P=0.001).结论 GEMOX方案对于经多种化疗方案治疗失败的淋巴瘤患者有较高的缓解率,患者耐受性好,部分患者能获得长期生存.对前次化疗敏感的淋巴瘤患者,GEMOX方案化疗的获益可能性更大.
목적 평개점서타빈연합오사리박(GEMOX)방안재다충화료방안치료실패후림파류환자중적료효화안전성.방법 회고성분석경2충혹2충이상적화료방안치료실패후、채용GEMOX방안진행해구화료적27례림파류환자,탐토기여림상료효상관적예측지표.결과 24례환자가평개근기료효,기중완전완해(CR)4례(16.7％),부분완해(PR)7례(29.1％),은정(SD)6례(25.0％),진전(PD)7례(29.1％),총완해솔위45.8％.재획득CR화PR적11례환자중,미만대B세포림파류4례,곽기금림파류4례,외주T세포림파류1례,투세포림파류1례,위점막상관림파조직림파류1례.전조환자적중위무진전생존시간(PFS)위8개월(95％ CI위1.6～14.4개월),11례획득CR화PR환자적중위PFS위19개월(95％ CI위11.1～26.8개월).불량반응주요위골수억제,기중출현Ⅲ～Ⅳ도중성립세포감소16례(59.3％),출현Ⅲ～Ⅳ도혈소판감소11례(40.7％).전차화료방안적민감성여GEMOX방안적완해솔상관,전차화료민감환자적GEMOX방안완해솔위83.3％,전차화료불민감환자적완해솔위31.2％,차이유통계학의의(P=0.001).결론 GEMOX방안대우경다충화료방안치료실패적림파류환자유교고적완해솔,환자내수성호,부분환자능획득장기생존.대전차화료민감적림파류환자,GEMOX방안화료적획익가능성경대.
Objective To evaluate the efficacy and safety of gemcitabine combined with oxaliplatin (GEMOX) in lymphoma patients after failure of multiple chemotherapy regimens.Methods The clinical data of 27 lymphoma patients,who received GEMOX regimen after failure of two or more prior chemotherapy regimens,were retrospectively reviewed.The predictive factors related to the clinical efficacy of GEMOX regimen were explored.Results The efficacy could be evaluated in 24 patients.Complete response was obtained in 4 patients (16.7％),partial response in 7 patients (29.1％),stable disease in 6 patients (25.0％),and progressive disease in 7 patients (29.1％),with an overall response rate of 45.8％.Among the eleven CR and PR patients,four patients were with diffuse large B cell lymphoma,four patients with Hodgkin's lymphoma,one with peripheral T cell lymphoma,one with mantle cell lymphoma and one with gastric mucosa-associated lymphoid tissue lymphoma.The median PFS time of the whole group was 8 months (95％ CI,1.6-14.4 months).For 11 CR and PR patients who had response to the GEMOX regimen,the median PFS time was 19 months (95％ CI,11.1-26.8 months).Major adverse response was hematologic toxicity.Among them,grade Ⅲ or Ⅳ neutropenia appeared in 16 patients (59.3％),and grade Ⅲ or Ⅳ thrombocytopenia appeared in 11 patients (40.7％).The sensitivity to the last chemotherapy was related to the efficacy of GEMOX regimen.The response rate was 83.3％ in patients who had response to the last chemotherapy,and only 31.2％ in the patients who failed to the last chemotherapy (P =0.001).Conclusions GEMOX regimen can get a better response rate in lymphoma patients after failure of multiple chemotherapy regimens,and with a good tolerance and acceptable safety.Some patients can get long-term survival.Patients sensitive to the last chemotherapy are more likely to benefit from GEMOX regimen.