EPOCH方案治疗非霍奇金淋巴瘤临床研究

A Clinical Study of EPOCH Regimen for Non-Hodgkin's Lymphoma

目的观察EPOCH方案治疗非霍奇金淋巴瘤的临床疗效和毒副反应。方法经病理确诊为非霍奇金淋巴瘤35例，采用EP—OCH方案化疗，VP-1650mg／m^2，ADM10mg／m^2或E-ADM12mg／m^2，VCR0．4mg／m^2，溶解于生理盐水500mL持续静滴24h，第1～4天；CTX750mg／m^2，静脉推注，第6天；强地松60mg／m^2，口服，第1～6天，21d为1周期。结果35例中CR／CRU11例（31．4％），PR17例（48．6％），总有效率80．O％，其中复治23例，CR／CRU6例（26．1％），PR11例（47．8％），总有效率73．9％。主要毒副反应为白细胞、血小板减少，其中Ⅲ-Ⅳ度发生率分别为34．2％（12／35）和42．9％（15／35），心房纤颤2．9％（1／35）。结论EPOCH方案是治疗非霍奇金淋巴瘤有效的治疗方案，耐受性较好，值得进一步研究。

Objective To observe the effect and toxicity of EPOCH regimen for patients with non-Hodgking lymphoma. Methods 35 patients with pathologically diagnosed non-Hodgkin＇ s lymphoma were treated by EPOCH regimen, in particular： VP-16 50 mg/m^2, ADM 10 mg/m^2 or E-ADM 12 mg/m^2 , VCR 0.4 mg/m^2 , dissolved in 500 mL saline sustained static drops 24 h on day 1 to 4 ; CTX 750 mg/m^2 , intravenous injection on day 6 ; oral prednisone 60 mg/m^2 on day 1 to 6 ; 21 days of a cycle. Results All the 35 patients were treated by EPOCH regimen. The response rate of the whole group was 80.0% , including CR/CRU 11 cases （31.4%） , PR 17 cases （48.6%）. The response rate of 23 patients with recurrence was 73.9% , including CR / CRU 6 cases （26.1%） , PR 11 cases （47.8 % ）. Main toxicity was myelosup- pression. The incidence of grade Ⅲ-IV neutropenia and thromboeytopenia respectively was 34.2% （12/35） and 42.9% （15/35） ; atrial fibrillation 2.9% （ 1/35）. Conclusion EPOCH regimen is effective for patients with non-Hodgkin＇ s lymphoma and better tolerance. EPOCH regimen is warranted with clinical study.