不同剂量硼替佐米治疗多发性骨髓瘤的近期疗效观察

Efficacy observation of different doses of bortezomib in the treatment of multiple myeloma

目的 观察不同剂量硼替佐米治疗多发性骨髓瘤的近期疗效和不良反应.方法 41例多发性骨髓瘤患者均给予硼替佐米为主的化疗方案治疗（硼替佐米1.0～1.3mg·m-1·d-1,第1、4、8、11天;多柔比星20mg/d,第1～4天;地塞米松20～40mg/d,第1～4天;联合或不联合沙利度胺100mg每晚睡前服用;21d为1个疗程）.根据硼替佐米应用剂量分为高剂量组（1.3mg·m-1·d-1）20例和低剂量组21例（1.0mg·m-1·d-1）,患者分别接受1～6个疗程的治疗.结果 41例患者给予不同剂量硼替佐米化疗方案后,高剂量组总有效率为85.0%高于低剂量组的71.4%,差异有统计学意义（P＜0.05）.高剂量组出现不良反应14例,低剂量组出现不良反应10例,2组比较差异无统计学意义（P＞0.05）.结论 硼替佐米应用高剂量（1.3mg·m-1·d-1）时对多发性骨髓瘤的临床疗效更好,虽有一定不良反应,但患者耐受良好.

Objective To observe the efficacy and adverse reaction of different doses of bortezomib in the treatment of multiple myeloma. Methods 43 cases of myeloma patients were treated with bortezomib which was the main medicine in chemotherapy regimen for treatment （ bortezomib 1.0 - 1.3mg·m-1·d-1, the 1 st,gth, 8th, 11 th day, doxorubicin 20mg/d, in 1-4 days;Combined with or without thalidomide 100mg,taking before going to bed every night;21d for 1 courses）. According to bortezomib dose, they were divided into high dose group （1.3mg ·m-1·d-1,20 cases）and low dose group （1.0mg ·m-1·d-1 ,21 cases）. All the Patients were treated for 1 - 6 courses. Results After treatment,the total effect rate of the high dose group was 85.0% ,which was higher than 71.4% of the low dose group, and the difference was statistically significant （P 〈 0.05 ）. 14 cases of patients occurred adverse reactions in high dose group, 10 cases of patients occurred adverse reactions in low dose group, there was no significant difference in 2 groups （ P 〉 0.05 ）. Conclusion The high dose bortezomib has greater clinical effect in the treatment of multiple myeloma. Although some adverse reaction, but the patients were well tolerated.