反应停联合DICE方案治疗难治性复发型非霍奇金淋巴瘤疗效分析

Clinical study of DICE combined thalidomide in treatment of relapsed or refractory non-Hodgkin's lymphoma

目的:观察反应停联合DICE方案治疗难治性复发型非霍奇金淋巴瘤(NHL)的临床疗效及不良反应。方法:将64例难治性/复发型NHL患者随机分为两组,对照组采用DICE方案治疗,治疗组采用反应停联合DICE方案治疗,以21d为1个周期,对完成4个周期以上者进行疗效评价随访1年和2年生存率。结果:治疗组32例中完全缓解(CR)l5例(46.88%),部分缓解(PR)8例(25.00%),总有效率71.88%;对照组32例中CR 8例(25.00%),PR 6例(18.75%),总有效率为46.88%,两组比较有显著性差异。治疗组1年生存率和2年生存率分别为81.25%(26/32)和56.25%(18/32),对照组1年生存率和2年生存率分别为75.0%(24/32)和40.62%(13/32),较之对照组,治疗组1年生存率有增加趋势,但统计学比较无差异,而2年生存率两组比较有统计学差异(P<0.05)。结论:反应停联合DICE方案治疗难治性复发型NHL疗效满意,不良反应可以耐受,值得进一步研究应用。

Objective：To evaluate the therapeutic effects and adverse reactions of combined thalidomide and DICE in the treatment of relapsed or refractory non-Hodgkin＇s lymphoma（NHL）.Methods： All 64 patients with refractory and relapsed NHL patients were randomly divided into two groups based,the control group was treated with DICE,treatment group was treated with thalidomide combined DICE,21days as one circle.The eficacy was evaluated after 4 circles.Results： The complete response rate,partial response rate,and total response rate were significantly higher in thalidomide combined DICE group than in DICE group（46.88% vs 25.00%,25.00% vs 18.75%,and 71.88%vs 46.88%,respectively,P0.05）;There was no difference in one year survival rate of two groups.But there was significant difference in two-year survival rate.Conclusion： Combined thalidomide with DICE has good therapeutic effect in advanced NHL,and its toxicity is well tolerated.Further clinical study on the application of thalidomide with DICE is needed.