脂质体多柔比星治疗淋巴瘤患者的疗效及安全性分析

The efficacy and safety of liposomal doxorubicin-based combined chemotherapy in lymphoma patients

背景与目的:蒽环类药物在淋巴瘤化疗中有很重要的地位,但相关不良反应限制了其在临床中的应用,尤其是心脏毒性。本文旨在分析脂质体多柔比星联合治疗淋巴瘤患者的有效率及安全性。方法:回顾性分析2006年1月—2011年10月在北京大学肿瘤医院淋巴肿瘤科住院并接受脂质体多柔比星联合化疗的68例患者的临床资料。其中初治患者47例,复治患者21例。应用SPSS 17.0统计软件统计分析治疗有效率和治疗相关不良反应,评价脂质体多柔比星的疗效及安全性。结果:68例患者中弥漫大B细胞淋巴瘤(diffuselarge B-cell lymphoma,DLBCL)42例。总有效率(ORR)为73.5%,其中完全缓解(CR)率57.4%,部分缓解(PR)率19.1%。初治DLBCL的ORR率为74.3%,CR率为60%,其中应用R-CCOP方案治疗患者的ORR率为81.5%,CR率为66.7%。骨髓抑制是最常见不良反应,3～4级粒细胞减少症的发生率55.9%;心电图异常发生率54.4%,3例患者出现心功能异常。仅1例伴有严重内科疾病的患者出现肺部感染并死亡。结论:使用脂质体多柔比星治疗淋巴瘤的有效率和安全性均较好。

Background and purpose： Anthracycline has a very important position in the chemotherapy of lymphoma. But its toxicity, particularly cardiac toxicity had limited its application. This study aimed to analyze the response rate and safety of liposomal doxorubicin in lymphoma patients. Methods： Clinical records of 68 lymphoma patients treated with liposomal doxorubicin-based combined chemo-regimen in Peking University Cancer Hospital from Jan. 2006 to Oct. 2011 were retrospectively analyzed, including 47 primary treated cases and 21 relapsed cases. SPSS 17.0 software was used to evaluate the efficacy and safety of liposomal doxorubicin. Results： Among the 68 patients, 47 cases were newly diagnosed, 42 patients were diagnosed as diffuse large B-cell lymphoma. The overall response rate （ORR） was 73.5%, complete remission （CR） rate was 57.4%, and partial remission （PR） rate was 19.1%. In the primary treatment diffuse large B-cell lymphoma （DLBCL） patients, the ORR was 74.3%, complete remission （CR） rate was 60%. The ORR in patients treated with R-CCOP regimen was 81.5%, CR was 66.7%. Myelosuppression was the major toxicity, in which grade 3 and 4 neutropenia accounted for 55.9%. Thirty-seven （54.4%） patients experienced with abnormal electrocardiogram, 3 patients suffered from cardiac dysfunction. Only one patient died of severe pulmonaryinfection. Conclusion： The application of liposomal doxorubicin in lymphoma patients shows a high efficacy and good safety.