右丙亚胺联合CHOP方案与单用CHOP方案治疗老年侵袭性非霍奇金淋巴瘤的临床研究

The efficacy and adverse reactions of dexrazoxane combined with CHOP regimen and CHOP regimen alone in treatment of elderly patients with aggressive non-Hodgkin lymphoma

目的比较右丙亚胺联合CHOP方案与单用CHOP方案治疗老年侵袭性非霍奇金淋巴瘤(NHL)的临床疗效和不良反应。方法选取2010-2013年接受诊治的老年侵袭性NHL患者196例,随机分为治疗组和对照组,每组98例。治疗组患者给予右丙亚胺联合CHOP方案治疗,对照组给予CHOP方案治疗。比较两组患者的临床总有效率和不良反应的发生情况。结果治疗组临床总有效率为77.6%,对照组临床总有效率为76.5%,比较无统计学差异(P>0 05);两组患者心电图异常发生率、TnT-I和心电超声Tei指数均有所增加,且治疗3个疗程后增加最明显,但治疗组显著低于对照组(均P<0.05);两组患者的非心脏不良反应如血白细胞减少、血小板减少、恶心、呕吐等发生情况均差异不大(均P>0.05)。结论与单用CHOP方案比较,联合使用右丙亚胺和CHOP方案治疗老年侵袭性NHL的临床疗效显著,且可以显著降低其心脏毒性,值得临床推广应用。

Objective To investigate the efficacy and the adverse reactions of dexrazoxane combined with CHOP regi-men and CHOP regimen alone in treatment of elderly patients with aggressive non- Hodgkin lymphoma. Methods One hundred and ninety six elderly patients with aggressive non- Hodgkin lymphoma admitted in Shaoxing People＆#39;s Hospital from January 2010 to January 2013 were randomly assigned to receive dexrazoxane combined with CHOP regimen or CHOP regimen alone with 98 cases in each group. The clinical efficacy rate and adverse reactions were compared between two groups. Results The clinical efficacy rates of combination and CHOP groups were 77.6%and 76.5%, respectively （P〉0.05）. The occurrence of elec-trocardiographic abnormality, the troponin I and the Tei index were increased and reached in the peak after 3 courses of treat-ment, however, the severity in combination group was milder than that in CHOP group（P〈0.05）. Conclusion CHOP regimen has satisfactory clinical efficacy in treatment of elderly patients with aggressive non- Hodgkin lymphoma, while combination of the regimen with dexrazoxane would reduce the cardiotoxicity of the treatment.