沙利度胺联合GLD方案治疗非霍奇金淋巴瘤的疗效分析

Efficacy of Thalidomide plus GLD Regimen in the Treatment of Non-Hodgkin Lymphoma

目的探讨沙利度胺联合由吉西他滨、奥沙利铂及地塞米松组成的GLD方案治疗复发或难治性非霍奇金淋巴瘤(NHL)的疗效及毒副作用。方法 26例经传统化疗方案化疗后复发或难治性NHL患者接受沙利度胺联合GLD方案治疗,化疗至少2个周期后评价疗效和毒副作用。结果全组26例患者中,完全缓解(CR)8例,部分缓解(PR)11例,疾病稳定(SD)4例,疾病进展(PD)3例,总有效率为73.1%(19/26),临床受益率88.5%(23/26),1年生存率为80.8%(21/26)。治疗后,血清血管内皮细胞生长因子(sVEGF)水平明显低于治疗前,差异有统计学意义(P<0.05)。主要毒副作用为骨髓抑制,其中Ⅲ～Ⅳ度白细胞减少8例,Ⅲ～Ⅳ度血红蛋白减少9例,Ⅲ～Ⅳ度血小板减少5例,经对症处理后未影响治疗的顺利进行;其他毒副作用均属Ⅰ～Ⅱ度。结论沙利度胺联合GLD方案治疗复发或难治性NHL疗效较好,毒副作用可耐受,值得临床推广应用。

Objective To investigate the efficacy and toxicities of thalidomide combined with GLD regimen （gemcitabine, oxaliplatin and dexamethasone） in the treatment of recurrent or refractory nonHodgkin＇s lymphoma （NHL） . Methods Twenty - six patients with recurrence or refractory NHL after medication of traditional chemotherapy accepted thalidomide combined with GLD regimen, the efficacy and toxicities were evaluated after at least 2 cycles of chemotherapy. Results Of the 26 cases, complete response （CR） was observed in the 8 cases, partial response （PR） in 11, stable disease （SD） in 4, and progressive disease （PD） in 3, with the total effective rate of 73.1% （19/26）, the clinical benefit rate of 88. 5% （23/26） ; and 1 - year survival rate of 80. 8% （21/26）. After the treatment, the serum vascular endothelial growth factor （sVEGF） level was significantly lower than that before treatment （ P 〈 0. 05 ）. The main toxicity was marrow suppression, including 8 cases of degree III - lV leucopeuia, 9 cases of degree III- IV reduced hemoglobin, and 5 case of degree III - IV thrombocytopenia ; however af- ter the symptomatic treatment, they did not affect the treatment. The other toxicities belonged all to degree I - II. Conclusion Thalidomide combined plus GLD is effect for recurrent or refractory NHL, and the toxicities can be tolerated.