硼替佐米联合地塞米松治疗多发性骨髓瘤的临床分析

Effect of Velcade combined with Dexamethasone on multiple myeloma

目的:比较硼替佐米(商品名Velcade)联合地塞米松(Velcade-Dexamethasone,VD)与改良VAD(Vinorebine+Pirarubicin+Dexamethasone)方案治疗多发性骨髓瘤的疗效及安全性。方法:36例多发性骨髓瘤患者,16例患者为VD方案治疗组,20例患者为改良VAD方案治疗组。采用欧洲血液和骨髓移植工作组(European Group for Blood and Marrow Transplant,EBMT)标准判定疗效,按照NCICTCAE(NationalCancer Institute Common Terminology Criteria for Adverse Events)标准判断不良反应。结果:VD方案组完全缓解(complete response,CR)为50%,部分缓解(partial response,PR)为25%,轻微缓解(minimal response,MR)为18.8%,无变化(no change,NC)为6.2%,疾病进展(progress disease,PD)为0%,总有效率为93.8%。改良VAD方案组CR为5%,PR为25%,MR为15%,NC为35%,PD为20%,总有效率为45%。χ2检验显示,两组方案的总有效率差异有统计学意义(P<0.05)。两组方案比较显示:VD方案副作用较轻,未见明显血液学及心脏毒性,对肾功能受损患者安全性好。结论:VD方案是一种新的有效治疗多发性骨髓瘤的方案,不良反应轻微,患者能耐受。

Objective To compare the effect and safety between Velcade-Dexamethasone（VD）and revised Vinorebine＋Pirarubicin＋ Dexamethasone（VAD） regiment for multiple myeloma（MM）.Methods Thirty-six patients with MM were reviewed,16 of whom were treated with VD（VD Group） and the others with VAD.European Group for Blood and Marrow Transplant（EBMT） criteria and National Cancer Institute Common Terminology Criteria for Adverse Events（NCICTCAE） were chosen to analyze the efficacy and side effects.Results In the VD group and the revised VAD group,the rates of complete response,partial response,minimal response,no change and progress disease were 50% vs.5%,25% vs.25%,18.8% vs.15%,6.2% vs.35% and 0 vs.20%,respectively.The total response rates were 93.8% vs 45%.There was significant difference in the overall response rate between the 2 groups（P0.05）.The side effects were less serious,and the endurance was better in the VD group than those in the revised VAD group.No serious effects of hematology and cardiology were seen,and good endurance was showed in the renal dysfunction in the VD group.Conclusion Velcade combined with dexamethasone is a safe and effective regiment for multiple myeloma with good safety and endurance.