标准的和2周一疗程CHOP方案治疗进展型非霍奇金氏淋巴瘤的随机对照研究

Randomized clinical trial of standard CHOP regimen and biweekly intensified CHOP regimen in the treatment of aggressive non Hodgkin's lymphoma

目的 :观察缩短常规CHOP方案的化疗间隙 ,能否提高进展型NHL的治疗效果。方法 :93例初治的进展型NHL被随机分成试验组和对照组 ,试验组 46例患者在G CSF的支持下使用 2周的CHOP方案治疗 ,对照组 47例病人用常规的 3周CHOP方案治疗 ,两方案的化疗药物剂量相同。结果 :试验组和对照组的CR率分别为 80 4%和 6 6 0 % ,2年DFS分别为 5 2 17%和 40 43 % ;按IPI属高中度 /高度危险性的患者在试验组和对照组的CR率为 76 9%和 3 7 5 % ,2年DFS为 3 8 46 %和 12 5 0 % ;按IPI属中低度 /低度危险性者在试验组和对照组的CR率为 81 8%和 80 6 % ,2年DFS为 5 7 88%和 5 4 84% ;两组患者的毒性反应相似 ,均可耐受。结论 :缩短CHOP方案的化疗间隙 ,有可能提高按IPI属中高度 /高度危险性进展型NHL患者的治疗效果 ,而中低度

Objective:To determine whether there were differences in the treatment of aggressive non Hodgkins lymphoma (ANHL),with standard CHOP regimen (SCHOP) or biweekly CHOP regimen (BCHOP) Methods:A total of 93 previously untreated ANHL patients were enrolled and randomly assigned to study group (BCHOP group) or control group (SCHOP group) Supporting by G CSF,BCHOP had same agent dose as SCHOP,but the interval of chemotherapy was shortened from three weeks to two weeks Results:Thirty seven of the 46 cases treated with BCHOP (80 4%) and 31 of the 47 cases treated with SCHOP (66 0%) had complete remissions Two year DFS of study group was 52 17%and 40 43%in control group The CR rates of the high/high intermediate risk group of international prognosis index (IPI) were 76 9%in BCHOP group versus 37 5%in SCHOP group The CR rates of the low/low intermediate risk group of IPI between study group and control group were similar (81 8%versus 80 6%) Two year DFS of the high/high intermediate risk group of IPI was 46 15%in BCHOP group versus 25 0%in SCHOP group There was no significant difference of two year DFS of the cases with low/low intermediate risk group of IPI between study group and control group (57 88%versus 54 84%) The toxicity in the two groups was similar and tolerated Conclusions:The CR rate and two year DFS of the high/high intermediate risk group of IPI in ANHL may be improved by BCHOP treatment compared with SCHOP treatment There is no significant difference in CR rates or two years DFS in the low/ low intermediate risk group of IPI between study group and control group The toxicity of BCHOP can tolerated throngh the support of G CSF