自体外周血干细胞移植支持下大剂量化疗治疗晚期恶性肿瘤的研究

High-dose chemotherapy in patients with terminal malignant tumors supported by autologous peripheral blood stem cells transplantation

目的观察自体外周血造血干细胞移植（APBHSCT）支持下大剂量化疗（HDC）治疗晚期恶性肿瘤（MT）的安全性及临床疗效。方法将常规挽救化疗4个周期后获CR或PR的晚期或复发恶性肿瘤患者随机分组，研究组26例行APBHSCT＋HDC，对照组50例继续2～4个周期常规化疗。结果研究组造血功能均重建，挽救化疗仅获PR的17例患者行APBHSCT＋HDC后8例获CR，有效率为47．1％；对照组继续常规化疗后，33例PR的患者仍为PR。中位生存期研究组比对照组延长11个月（P〈0．05）。2年、3年、4年生存率研究组比对照组明显提高（P〈0．05）。结论APBHSC＋HDC治疗恶性肿瘤是一种安全有效的方法，可延长晚期或复发肿瘤患者的生存期和提高生存率。

Objective To observe the safety and effectiveness of high-dose chemotherapy （HDT） supported by autologous peripheral blood hematopoietic stem cells transplantation （APBHSCT） in the patients of terminal or relapsed malignant tumors. Methods The patients achieved CR or PR after 4 cycles of conventional salvage chemotherapy were divided into two groups randomly. 26 patients in the research group were adapted APBHSC ＋ HDC, 50 patients in the control group were adapted 2 -4 cycles of routine chemotherapy. Results In the research group, hematopoiesis was reconstructed in all patients, 8 out of 17 patients who achieved PR after 4 cycles of conventional salvage chemotherapy turned into CR after APBHSC ＋ HDC （ CR rate 47. 1% ） . In the control group, 33 patients who achieved PR after 4 cycles of conventional salvage chemotherapy were still PR after 2 -4 cycles of routine chemotherapy. The median survival period in the research group was 11 months, which was longer than the one in the control group. The survival rates of 2, 3 and 4 years in the research group were evidently higher than the ones in the control group（ P 〈0.05）. Conclusion APBHSC ＋ HDC is safe and effective for patients with malignant tumors. It can prolong the median survival period and increase the survival rate in patients of terminal and relapsed malignant tumors.