改良VDLP方案治疗NK/T细胞淋巴瘤的临床观察

Clinical effects of modified VDLP regimen for patients with newly diagnosed NK/T-cell lymphoma

为了探讨左旋门冬酰胺酶为主的改良VDLP方案治疗NK/T细胞淋巴瘤的疗效及毒副反应,分析2006-03-1-2009-10-1我院收治的24例初治NK/T细胞淋巴瘤患者,治疗方案均选用改良VDLP方案,所有患者均接受2～6个周期,中位3.5个周期,病灶局限的患者,化疗后加用侵犯野放疗。24例患者中,总有效率70.8%(17/24),完全缓解率(CR)62.5%(15/24),部分缓解率(PR)8.3%(2/24),病情稳定(SD)12.5%(3/24),4例恶化(PD)16.6%(4/24)。中位随访26(12～49)个月,全组预期3年生存率为66.7%;主要不良反应为骨髓抑制,Ⅲ～Ⅳ度粒细胞减少占25%,无治疗相关死亡。初步研究提示,左旋门冬酰胺酶为主的VDLP方案治疗NK/T细胞淋巴瘤疗效好,毒副反应小且耐受性好,值得临床推荐使用。

The objective of this study was to evaluate treatment outcomes and toxicity of modified VDLP regimen for NK/T-cell lymphoma. From march 1, 2006 to October 1, 2009,24 newly diagnosed patients with nasal NK/ T cell lymphoma received modified VDLP protocols as first-line treatment. All patients received median 3.5 （2-6） cycles. Additional involved field irradiation was administered to patients with localized nasal focus after chemotherapy. The response rate （RR） was 70.8 % （17/24）, with complete remission（CR） rate of 62.5 % （15/24）, partial remission（PR） rate of 8.3% （2/24）, stable disease（SD） 12. 5% （3/24） ,progressive disease （PD） 16. 6% （4/24）. After a median follow-up of 26（12-49） months, the estimated 3-year overall survival rate （OS） was 66.7%. Major adverse effect was myelosuppression. The incidence of grade III - IV neutropenia was 25 %. No treatment-related mortality occurred. In conclusion, modified VDLP protocol was effective and well tolerant for nasal NK/T cell lymphoma.