中国药业
中國藥業
중국약업
CHINA PHARMACEUTICALS
2015年
1期
78-79,80
,共3页
多发性骨髓瘤%硼替佐米%地塞米松%吡柔比星%不良反应
多髮性骨髓瘤%硼替佐米%地塞米鬆%吡柔比星%不良反應
다발성골수류%붕체좌미%지새미송%필유비성%불량반응
multiple myeloma%bortezomib%dexamethasone%pirarubicin%adverse reactions
目的：比较硼替佐米联合吡柔比星、地塞米松（BAD）与长春新碱联合比柔比星、地塞米松( VAD )治疗初治多发性骨髓瘤的疗效。方法将32例初治多发性骨髓瘤患者随机分为两组，BAD组（14例）予BAD方案治疗，硼替佐米1.3 mg/m2，第1，4，8，11天静脉注射；地塞米松40 mg/d，第1~4天静脉滴注；吡柔比星10 mg/（m2·d），第1~4天静脉注射；每3周为1个疗程。VAD组（18例）患者予VAD方案治疗，长春新碱0.4 mg/（m2·d），第1~4天静脉滴注；吡柔比星10 mg/（m2·d），第1~4天静脉注射；地塞米松40 mg，分早、晚2次口服，第1~4天；每4周为1个疗程。结果 BAD 组患者有效率为78.57%，与 VAD 组的61.11%差异无统计学意义( P>0.05)。但观察组完全缓解( CR )+接近完全缓解( nCR )率为57.14%，明显高于VAD组的16.67%（ P<0.05)，且不良反应发生率未明显增加。结论硼替佐米联合吡柔比星、地塞米松治疗初治多发性骨髓瘤患者，虽然总有效率与传统化疗方案无明显差异，但完全缓解及接近完全缓解率明显较高，不良反应少且可耐受，可安全用于肾功能不全的患者。
目的：比較硼替佐米聯閤吡柔比星、地塞米鬆（BAD）與長春新堿聯閤比柔比星、地塞米鬆( VAD )治療初治多髮性骨髓瘤的療效。方法將32例初治多髮性骨髓瘤患者隨機分為兩組，BAD組（14例）予BAD方案治療，硼替佐米1.3 mg/m2，第1，4，8，11天靜脈註射；地塞米鬆40 mg/d，第1~4天靜脈滴註；吡柔比星10 mg/（m2·d），第1~4天靜脈註射；每3週為1箇療程。VAD組（18例）患者予VAD方案治療，長春新堿0.4 mg/（m2·d），第1~4天靜脈滴註；吡柔比星10 mg/（m2·d），第1~4天靜脈註射；地塞米鬆40 mg，分早、晚2次口服，第1~4天；每4週為1箇療程。結果 BAD 組患者有效率為78.57%，與 VAD 組的61.11%差異無統計學意義( P>0.05)。但觀察組完全緩解( CR )+接近完全緩解( nCR )率為57.14%，明顯高于VAD組的16.67%（ P<0.05)，且不良反應髮生率未明顯增加。結論硼替佐米聯閤吡柔比星、地塞米鬆治療初治多髮性骨髓瘤患者，雖然總有效率與傳統化療方案無明顯差異，但完全緩解及接近完全緩解率明顯較高，不良反應少且可耐受，可安全用于腎功能不全的患者。
목적：비교붕체좌미연합필유비성、지새미송（BAD）여장춘신감연합비유비성、지새미송( VAD )치료초치다발성골수류적료효。방법장32례초치다발성골수류환자수궤분위량조，BAD조（14례）여BAD방안치료，붕체좌미1.3 mg/m2，제1，4，8，11천정맥주사；지새미송40 mg/d，제1~4천정맥적주；필유비성10 mg/（m2·d），제1~4천정맥주사；매3주위1개료정。VAD조（18례）환자여VAD방안치료，장춘신감0.4 mg/（m2·d），제1~4천정맥적주；필유비성10 mg/（m2·d），제1~4천정맥주사；지새미송40 mg，분조、만2차구복，제1~4천；매4주위1개료정。결과 BAD 조환자유효솔위78.57%，여 VAD 조적61.11%차이무통계학의의( P>0.05)。단관찰조완전완해( CR )+접근완전완해( nCR )솔위57.14%，명현고우VAD조적16.67%（ P<0.05)，차불량반응발생솔미명현증가。결론붕체좌미연합필유비성、지새미송치료초치다발성골수류환자，수연총유효솔여전통화료방안무명현차이，단완전완해급접근완전완해솔명현교고，불량반응소차가내수，가안전용우신공능불전적환자。
Objective To compare the efficacy between bortezomib plus pirarubicin and dexamethasone ( BAD ) and vincristine plus piraru-bicin and dexamethasone ( VAD ) as the initial therapy for treating newly diagnosed multiple myeloma ( MM ) . Methods 32 patients with MM in our hospital were randomly divided into two groups. The BAD group ( 14 cases ) were treated with bortezomib 1. 3 mg/ ( m2 · d ) by intravenous injection on 1, 4, 8, 11 d, dexamethasone 40 mg/d by intravenous infusion on 1-4 d and pirarubicin 10 mg/ (m2·d) by intravenous injection on 1-4 d for 3 weeks as 1 course of treatment. The VAD group (18 cases) were treated by vincristine 0. 4 mg/(m2·d) by intravenous injection on 1-4 d, pirarubicin 10 mg/ ( m2 · d ) by intravenous injection on 1-4 d and dexamethasone 40 mg/d twice daily as oral administration on 1-4 d for 4 weeks as 1 course of treatment. Results :The overall response ( OR ) rate was 78. 57% in the BAD group and 61. 11% in the VAD group with no statistically significant difference ( P>0. 05 ) . But the complete remission ( CR ) plus the near-CR ( nCR ) rate in the BAD group was 57. 14%, which was significantly higher than 16. 67% in the VAD group;the dif-ference showed the statistical significance ( P<0. 05 ) , moreover without increasing the occurrence rate of adverse reactions. Conclusion Although the OR rate in the BAD scheme for the initial therapy of MM has no obvious difference compared with the traditional chemotherapy scheme, but CR+nCR is significantly higher with less and tolerable adverse reactions, and can be safely used in the pa-tients with renal dysfunction.
