摘要
目的:探讨PAD方案(硼替佐米、阿霉素和地塞米松)与T-VAD方案(沙利度胺联合长春地辛、阿霉素、地塞米松)治疗初治多发性骨髓瘤的疗效与安全性。方法:回顾分析47例初治多发性骨髓瘤患者的治疗情况,其中PAD治疗组23例,TVAD治疗组24例。结果:PAD治疗组总有效率91.3%(21/23),其中完全缓解(complete response,CR)8例(34.8%),很好的部分缓解(very good partial response,VGPR)3例(13.0%),部分缓解(partial response,PR)10例(43.5%),疾病稳定(stable disease,SD)2例(8.7%)。T-VAD治疗组总有效率66.7%(16/24),其中CR 4例(16.7%),VGPR 2例(8.3%),PR 10例(41.7%),SD 5例(20.8%),疾病进展(progressive disease,PD)3例(12.5%)。2组疗效比较差异有统计学意义(P<0.05)。PAD组的不良反应为:便秘5例(21.7%),腹泻4例(17.4%),恶心3例(13.0%);中性粒细胞减少3例(13.0%),贫血2例(8.7%),血小板下降2例(8.7%);乏力2例(8.7%);带状疱疹6例(26.1%);周围神经病变5例(21.7%)。T-VAD组患者均有便秘(100%),嗜睡15例(62.5%),皮疹2例(8.3%),带状疱疹1例(4.2%),下肢水肿2例(8.3%),深静脉血栓1例(4.2%)。2组患者均未发生严重的不良反应。结论:PAD和T-VAD方案均具有良好的安全性,而PAD方案对初治多发性骨髓瘤的疗效较好。
Objective:To study the efficacy and safety of PAD regimen(bortezomib + adriamycin + dexamethasone) and T-VAD regimen(vindesine + adriamycin + dexamethasone + thalidomide) in the treatment of newly diagnosed multiple myeloma (MM).Methods:A total of 47 patients with newly diagnosed MM were involved.Twenty-three patients were treated with PAD regimen.Twenty-four patients were treated with T-VAD regimen.Results:The overall response rate with PAD regimen was 91.3%(21/23),with complete response(CR) in 8 cases(34.8%),very good partial response(VGPR) in 3 cases(13.0%),partial response(PR) in 10 cases(43.5 %),stable disease(SD) in 2 cases(8.7 %).The overall response rate with T-VAD regimen was 66.7%(16/24),with CR in 4 cases(16.7%),VGPR in 2 cases(8.3%),PR in 10 cases(41.7%),SD in 5 cases (20.8%),progressive disease(PD) in 3 cases(12.5 %).There was significant difference in efficacy between the two groups(P<0.05).The adverse events with PAD regimen included constipation in 5 cases(21.7 %),diarrhea in 4 cases(17.4 %),nausea in 3 cases (13.0 %),neutropenia in 3 cases (13.0 %),anemia in 2 cases (8.7 %),thrombocytopenia in 2 cases (8.7 %),weak in 2 cases (8.7 %),herpes zoster in 6 cases(26.1%),peripheral neuropathy in 5 cases(21.7%).The adverse events with T-VAD regimen included constipation in 24 cases(100%),somnolence in 15 cases(62.5%),rash in 2 cases(8.3%),herpes zoster in 1 case (4.2 %),edema of lower extremity in 2 cases(8.3 %),deep venous thrombosis in 1 case(4.2 %).No severe side effects were observed in both therapies.Conclusions:Both therapies are safe,and PAD is more effective than T-VAD regimen for patients with newly diagnosed MM.
出处
《中国临床医学》
2013年第5期670-672,共3页
Chinese Journal of Clinical Medicine