沙利度胺联合化疗治疗多发性骨髓瘤的临床观察

Thalidomide combined with chemotherapy in treatment of multiple myeloma

目的：探讨沙利度胺联合化疗治疗多发性骨髓瘤的临床疗效及不良反应。方珐：治疗组21例采用沙利度胺联合化疗，沙利度胺自化疗开始给药，剂量200mg／d，分早、晚口服，4周后无效增至300mg／d，维持该剂量半年。化疗方案分别为MP、VAD、VMCP。1个月为1个疗程。对照组24例，单纯化疗，化疗的方案、药物的剂量均同治疗组。结果：治疗组部分缓解13例，进步4例，无效4例，总有效率80，95％，明显高于对照组（总有效率54．17％）（P〈0．01）；治疗组主要疗效指标的改善率均优于对照组（P〈0．05-P〈0．005）。常见的不良反应有便秘、嗜睡、皮疹、两下肢水肿等，但均可耐受。结论：沙利度胺联合化疗治疗多发性骨髓瘤具有副作用少、耐受性好、给药方便、疗效明显的优点，值得临床深入研究和推广应用。

Objective：To study the curative effect and side effect of thalidomide combined with chemotherapy in treatment of multiple myeloma. Methods：The treatment group（21 cases） was administered thalidomide at a dose of 200 mg/d and chemotherapy. The dosage increased to 300 mg/d after 4 weeks when the effect was not satisfactory, which was maintained for half a year. The chemotherapy regimens were MP,VAD and VMCP. The control group（24 cases） was given chemotherapy only. The chemotherapy regimens and doses were the same with the treatment group. Results： In the treatment group,3 cases had partial relief（61.90% ）,4 cases improved （ 19.05 % ） and 4 cases had no： response （ 19.05 % ）. The total efficacy rate was 80.95 % , which was significantly higher than that of the control group（ with a total efficacy rate of 54..17% ） （ P 〈 0.01 ） . The improvement rate of most indexes in the treatment group was higher than that in the control group（ P 〈 0.05 - P 〈 0. 005 ）. The side effects included constipation,lethargy, dermatitis and edema in the two low limbs,which were all tolerable. Conclusions： Thalidomide combined with chemotherapy in treatment of multiple myeloma has the merits of fewer side effects, good tolerance,convenient administration and significant curative effect. It is worth popularizing.