CAJ | 학술논문

目的观察含左旋门冬酰胺酶(L-ASP)的联合化疗方案治疗初发外周T细胞淋巴瘤的疗效和不良反应.方法回顾性分析浙江大学医学院附属第一医院2012年1月至2013年12月接受含L-ASP与不含L-ASP的联合化疗方案治疗的初发外周T细胞淋巴瘤102例,前者(含L-ASP组)42例,后者(不含L-ASP组)60例,比较两组的近期疗效如完全缓解(CR)率、部分缓解(PR)率和总有效(OR)率,以及远期疗效如总生存(OS)率、无进展生存(PFS)率及不良反应.结果含L-ASP组的OR率明显高于不含L-ASP组[83.3％(35/42)比61.7％ (37/60),P=0.016],其中在分期为Ⅲ/Ⅳ期[82.4％(28/34)比54.0％(27/50),P=0.007]和国际预后指数(IPI)评分≥2分[82.1％(23/28)比50.0％ (21/42),P=0.006]的患者中尤其明显.含L-ASP组的3年OS率为48.9％,不含L-ASP组为65.0％,差异无统计学意义(P=0.974);含L-ASP组的3年PFS率为40.8％,不含L-ASP组为61.0％,差异也无统计学意义(P=0.479).含L-ASP组虽然不良反应较不含L-ASP组多,但多为轻度,经对症支持治疗后均可好转,Ⅲ～Ⅳ度中性粒细胞减少引起的严重发热两组无明显差异(P=0.777),含L-ASP组其他严重不良反应如脑出血、急性胰腺炎均只发生1例.结论含L-ASP的联合化疗方案治疗初发外周T细胞淋巴瘤显示了较好的近期疗效,且不良反应可控.L-ASP用于一线治疗外周T细胞淋巴瘤的大型前瞻性临床试验值得开展和深入研究.
목적 관찰함좌선문동선알매(L-ASP)적연합화료방안치료초발외주T세포림파류적료효화불량반응.방법 회고성분석절강대학의학원부속제일의원2012년1월지2013년12월접수함L-ASP여불함L-ASP적연합화료방안치료적초발외주T세포림파류102례,전자(함L-ASP조)42례,후자(불함L-ASP조)60례,비교량조적근기료효여완전완해(CR)솔、부분완해(PR)솔화총유효(OR)솔,이급원기료효여총생존(OS)솔、무진전생존(PFS)솔급불량반응.결과 함L-ASP조적OR솔명현고우불함L-ASP조[83.3％(35/42)비61.7％ (37/60),P=0.016],기중재분기위Ⅲ/Ⅳ기[82.4％(28/34)비54.0％(27/50),P=0.007]화국제예후지수(IPI)평분≥2분[82.1％(23/28)비50.0％ (21/42),P=0.006]적환자중우기명현.함L-ASP조적3년OS솔위48.9％,불함L-ASP조위65.0％,차이무통계학의의(P=0.974);함L-ASP조적3년PFS솔위40.8％,불함L-ASP조위61.0％,차이야무통계학의의(P=0.479).함L-ASP조수연불량반응교불함L-ASP조다,단다위경도,경대증지지치료후균가호전,Ⅲ～Ⅳ도중성립세포감소인기적엄중발열량조무명현차이(P=0.777),함L-ASP조기타엄중불량반응여뇌출혈、급성이선염균지발생1례.결론 함L-ASP적연합화료방안치료초발외주T세포림파류현시료교호적근기료효,차불량반응가공.L-ASP용우일선치료외주T세포림파류적대형전첨성림상시험치득개전화심입연구.
Objective To investigate the efficacy and adverse effects of L-asparaginase (L-ASP) containing regimens in patients with newly diagnosed peripheral T-cell lymphoma.Methods A total of 102 newly diagnosed patients with peripheral T-cell lymphoma who received combination chemotherapy with or without L-ASP were enrolled in the study between January 2011 and December 2013 in our hospital.Therapeutic and adverse effects were retrospectively analyzed,including the short-term efficacy such as complete remission (CR) rate,partial remission (PR) rate,overall remission (OR) rate,and long-term efficacy such as overall survival(OS) rate,progressive free survival(PFS) rate.Results The OR rate in patients treated with L-ASP containing regimens (L-ASP group) was apparently higher than the patients treated without L-ASP (non L-ASP group) [83.3％ (35/42) vs 61.7％ (37/60),P =0.016].Furthermore,the difference was especially significant in patients with stage Ⅲ/Ⅳ [82.4％ (28/34) vs 54.0％(27/50),P=0.007] or IPI seore≥2 [82.1％(23/28) vs50.0％(21/42),P=0.006].The 3-year OS rate of L-ASP group and non L-ASP group were 48.9％ and 65.0％ respectively(P =0.974).Three-year PFS rate of L-ASP group and non L-ASP group were 40.8％ and 61.0％ respectively (P =0.479).Neither had statistical significance.Although the incidence of adverse effects was higher in L-ASP group,most of them were mild and controllable after supportive treatment.There was no significant difference in serious infections caused by Ⅲ-Ⅳ degree neutropenia between the two groups (P =0.777).Other severe side-effects in L-ASP group such as hematencephalon and acute pancreatitis were only seen in one case respectively.Conclusions Combination chemotherapy with L-ASP showed better short-term efficacy in newly diagnosed peripheral T-cell lymphoma patients and the adverse effects were controllable.Large scale prospective clinical trial of using L-ASP in peripheral T-cell lymphoma is worthy of developing and further studying.