GDP方案挽救治疗复发难治性非霍奇金淋巴瘤的临床研究

GDP regimen as salvage treatment for relapsed refractory non-Hodgkin＇ s lymphoma

目的研究GDP方案挽救治疗复发难治性非霍奇金淋巴瘤（NHL）的近期疗效及安全性。方法回顾性分析接受GDP方案治疗的34例NHL患者的近期疗效及不良反应。GDP方案：吉西他滨1000mg／m2静脉滴注，第1、8天，顺铂25mg／m2静脉滴注，第1天至第3天，地塞米松40mg／d静脉滴注，第1天至第4天，21d为1个周期，2个周期后评估疗效。结果总有效率（ORR）为52．9％（18／34）。复发性NHLORR为72．7％（8／11），难治性NHL为43．5％（10／23），二者比较差异无统计学意义（P=0．11）；B—NHLORR为64．0％（16／25），T—NHL为22．2％（2／9），两组比较差异无统计学意义（P=0．052）；低危组ORR为66．7％（6／9），中危组为55．6％（10／18），高危组为28．6％（2／7），低中危组的疗效优于高危组，但差异无统计学意义（P=0．349）。Ⅲ～Ⅳ度粒细胞减少发生率为23．5％（8／34），无Ⅲ。Ⅳ度胃肠道不良反应及肝肾毒性。结论GDP方案是复发难治性NHL的一种高效、低毒的二线挽救治疗方案。

Objective To study the effect and safety of GDP regimens （gemcitabine, cisplatin, dexamethasone） as salvage chemotherapy in relapsed refractory non-Hodgkin＇s lymphoma （NHL）. Methods Clinical response and adverse effects of 34 NHL patients treated by GDP regimens were analyzed retrospectively. Results The overall response rate （ORR） was 52.9 % （18/34）, there was no statistic difference between ORR in relapsed NHL [72.7 % （8/11）] and that in refractory ones [43.5 % （10/23）] （P = 0.11）. The ORR for B-NHL was 64.0 % （16/25）, while for T-NHL was 22.2 % （2/9）, there was no statistic difference between them （P = 0.052）. The ORR for low risks groups was 66.7 % （6/9）, while it for intermediate-risk and high-risk ones were 55.6 % （10/18） and 28.6 % （2/7）, respectively, the effect of GDP regimens for low-risk group was better for high-risk ones, but there was no statistic difference （P = 0.349）. The ineedience of III- IV granulopenia reduced was 23.5 % （8/34） and there were no III- IV gastrointestinal adverse reactions or liver and kidney toxicity. Conclusion GDP regimens were efficient and less toxic as second-line salvage chemotherapy.