硼替佐米联合地塞米松、沙利度胺方案治疗多发性骨髓瘤的疗效

Efficacy of bortezomib,dexamethasone combined with thalidomide in the treatment of multiple myeloma

目的探讨硼替佐米联合地塞米松、沙利度胺方案治疗多发性骨髓瘤(MM)的临床疗效及不良反应。方法选取姜堰市人民医院2009年1月至2012年3月经硼替佐米联合地塞米松、沙利度胺(VDT)方案治疗的MM患者14例作为VDT组(观察组),并选取2007年1月至2012年3月在我院接受VAD方案治疗的16例MM患者作为VAD组(对照组),观察两组治疗效果及安全性。结果 VDT组完全缓解率为42.86%(6/14),部分缓解率为35.71%(5/14),微小缓解率为14.29%(2/14),无效率为7.14%(1/14),总有效率为92.86%;VAD组完全缓解(CR)率12.50%(2/16),部分缓解(PR)率50.00%(8/16),微小缓解率为12.50%(2/16),无效率为25.00%(4/16),总有效率为75.0%,两组相比差异有统计学意义(P<0.05);VDT组在降低M蛋白,使骨髓瘤细胞下降方面与VAD组相比差异有统计学意义(P<0.05)。结论硼替佐米联合地塞米松及沙利度胺方案治疗多发性骨髓瘤(MM)具有耐受性好、疗效明显的优点,可以作为一线治疗方案使用。

Objective To study the clinical effect and side effect of bortezomib combined with dexamethasone and thalido- mide in treatment of multiple myeloma. Methods Fourteen patients with muhiple myeloma（MM） treated with bortezomib, dexa- methasone and thalidomide （VDT） between January 2009 and March 2012 in our department （ Departmont of Hematology, Jiongyon People＇ s Hospitoll） were selected as the VDT group, 16 cases of MM treated in our department between January 2007 and to March 2012 with VAD （vinorelbine ＋ doxorubicin ＋ dexamethasone） were selected as the VAD group. The effects and safety were observed. Results The VDT group had 6 cases （42. 86% ） of complete response（ CR）, 5 cases （ 35.71% ） of par- tial response（PR）, 2 cases（ 14. 29% ） of minimal response（ MR）, 1 case（7. 14% ） of inefficacy, and the total effective rate was 92. 86%. There were 2 cases（12. 50% ） of CR, 8 cases（50. 00% ） of PR, 2 cases（12. 50% ） of MR, 4 cases（25.00% ） of inefficacy in VAD group, and the total effectioe rate was 75.0%. There were significant differerces between the two groups （ P 〈 0. 05 ） . Conclusions Bortezomib combined with dexamethasone and thalidomide in the treatment of multiple myeloma has the advantage of less side effect, good tolerance, and obuious curative effect, so is worth to be widely popularized in clinics.