CAJ | 학술논문

目的：评价环磷酰胺＋表柔比星＋长春新碱＋泼尼松（ CHOP方案）联合沙利度胺治疗侵袭性非霍奇金淋巴瘤的临床疗效及安全性。方法将72例非霍奇金淋巴瘤患者随机分为对照组35例与试验组37例。对照组予以CHOP方案化疗（静脉注射600 mg? m－2环磷酰胺，第1天＋静脉注射40 mg? m－2表柔比星，第1天＋静脉注射1．4 mg? m－2长春新碱，第1天＋口服50 mg? m－2泼尼松，第1～7天）；试验组在对照组的基础上，加用口服沙利度胺200 mg，第1～14天，自第2个疗程增量至400 mg，第1～14天。2组患者共治疗4个周期，每个周期为28 d。比较2组患者的客观缓解率、治疗后第1，2年生存率和不良反应发生率。结果治疗后，试验组客观缓解率为78．38％显著高于对照组57．14％（P＜0．05）。对照组1年生存率及2年生存率分别为65．71％，40．00％均显著低于试验组81．08％，62．16％（ P＜0．05）。2组患者不良反应（白细胞降低、恶心与呕吐、脱发、贫血、肝功能损伤）的发生率比较差异无统计学意义（ P＞0．05）。结论沙利度胺联合CHOP方案治疗侵袭性非霍奇金淋巴瘤的临床疗效显著，且不增加不良反应的发生率。
목적：평개배린선알＋표유비성＋장춘신감＋발니송（ CHOP방안）연합사리도알치료침습성비곽기금림파류적림상료효급안전성。방법장72례비곽기금림파류환자수궤분위대조조35례여시험조37례。대조조여이CHOP방안화료（정맥주사600 mg? m－2배린선알，제1천＋정맥주사40 mg? m－2표유비성，제1천＋정맥주사1．4 mg? m－2장춘신감，제1천＋구복50 mg? m－2발니송，제1～7천）；시험조재대조조적기출상，가용구복사리도알200 mg，제1～14천，자제2개료정증량지400 mg，제1～14천。2조환자공치료4개주기，매개주기위28 d。비교2조환자적객관완해솔、치료후제1，2년생존솔화불량반응발생솔。결과치료후，시험조객관완해솔위78．38％현저고우대조조57．14％（P＜0．05）。대조조1년생존솔급2년생존솔분별위65．71％，40．00％균현저저우시험조81．08％，62．16％（ P＜0．05）。2조환자불량반응（백세포강저、악심여구토、탈발、빈혈、간공능손상）적발생솔비교차이무통계학의의（ P＞0．05）。결론사리도알연합CHOP방안치료침습성비곽기금림파류적림상료효현저，차불증가불량반응적발생솔。
Objective To investigate the clinical efficacy and safety of CHOP chemotherapy regiment combined with thalidomide in the treatment of aggressive non-hodgkin′s lymphoma.Methods Seventy-two cases of aggressive non-hodgkin′s lymphoma were recruited in this study and randomly divided into control group ( n =35 ) and treatment group (n=37). Patients in the control were given CHOP chemotherapy ( cyclophosphamide 600 mg ? m-2 intravenous injection, day 1+epirubicin 40 mg? m-2 ntravenous injection, day 1+vinblastine 1.4 mg? m-2 ntravenous injection, day 1+dehydrocortisone 50 mg? m-2 , orally, day 1-7).Patients in the treatment group were given CHOP chemotherapy regiment combined with thalidomide ( thalidomide 200 mg, day 1 -14, orally, at the second phrase thalidomide 400 mg, day 1-14).After 4 cycles treatment, the objective response rate, 1 and 2 year survival rate and chemotherapy associated toxicity were assessed between the two groups. Results The objective response rate were 78.38% and 57.14% in the treatment and control group respectively with the treatment group statistical higher than control group( P<0.05). The 1 and 2 years survival rate were 65.71%and 40.00%in the control group which was significant lower than that in the treatment group(1 and 2 years survival rate 81.08%, 62.16%, P<0.05) .The chemotherapy associated toxicity such as granulopenia, nausea and vomiting, alopecie and et al had no statistical difference between the two groups (P>0.05).Conclusion CHOP chemotherapy regiment combined with thalidomide can improve the objective response rate without increasing the toxicity in treatment of aggressive non-hodgkin′s lymphoma.