沙利度胺联合CHOP方案治疗侵袭性非霍奇金淋巴瘤的临床疗效及安全性评价

Clinical efficacy and safety of thalidomide combined with CHOP regiment in the treatment of aggressive non-hodgkin's lymphoma

目的评价环磷酰胺＋表柔比星＋长春新碱＋泼尼松（CHOP方案）联合沙利度胺治疗侵袭性非霍奇金淋巴瘤的临床疗效及安全性。方法将72例非霍奇金淋巴瘤患者随机分为对照组35例与试验组37例。对照组予以CHOP方案化疗（静脉注射600 mg·m^-2环磷酰胺,第1天＋静脉注射40 mg·m^-2表柔比星,第1天＋静脉注射1.4 mg·m^-2长春新碱,第1天＋口服50 mg·m^-2泼尼松,第1-7天）;试验组在对照组的基础上,加用口服沙利度胺200 mg,第1-14天,自第2个疗程增量至400 mg,第1-14天。2组患者共治疗4个周期,每个周期为28 d。比较2组患者的客观缓解率、治疗后第1,2年生存率和不良反应发生率。结果治疗后,试验组客观缓解率为78.38%显著高于对照组57.14%（P〈0.05）。对照组1年生存率及2年生存率分别为65.71%,40.00%均显著低于试验组81.08%,62.16%（P〈0.05）。2组患者不良反应（白细胞降低、恶心与呕吐、脱发、贫血、肝功能损伤）的发生率比较差异无统计学意义（P〉0.05）。结论沙利度胺联合CHOP方案治疗侵袭性非霍奇金淋巴瘤的临床疗效显著,且不增加不良反应的发生率。

Objective To investigate the clinical efficacy and safety of CHOP chemotherapy regiment combined with thalidomide in the treatment of aggressive non- hodgkin＇s lymphoma. Methods Seventy- two cases of aggressive non- hodgkin＇s lymphoma were recruited in this study and randomly divided into control group（ n = 35） and treatment group（ n = 37）. Patients in the control were given CHOP chemotherapy（ cyclophosphamide 600 mg · m^- 2intravenous injection, day1 ＋ epirubicin 40 mg·m^- 2ntravenous injection,day 1 ＋ vinblastine 1. 4mg·m^- 2ntravenous injection,day 1 ＋ dehydrocortisone 50 mg ·m^- 2,orally,day 1- 7）. Patients in the treatment group were given CHOP chemotherapy regiment combined with thalidomide（ thalidomide 200 mg,day 1- 14,orally,at the second phrase thalidomide 400 mg,day1- 14）. After 4 cycles treatment,the objective response rate,1 and 2year survival rate and chemotherapy associated toxicity were assessed between the two groups. Results The objective response rate were78. 38% and 57. 14% in the treatment and control group respectively with the treatment group statistical higher than control group（ P〈0. 05）.The 1 and 2 years survival rate were 65. 71% and 40. 00% in the control group which was significant lower than that in the treatment group（ 1 and 2 years survival rate 81. 08%,62. 16%,P〈0. 05）. The chemotherapy associated toxicity such as granulopenia,nausea and vomiting,alopecie and et al had no statistical difference between the two groups（ P〉0. 05）. Conclusion CHOP chemotherapy regiment combined with thalidomide can improve the objective response rate without increasing the toxicity in treatment of aggressive non- hodgkin＇s lymphoma.