以培门冬酶为基础的GELOX方案治疗结外鼻型NK/T细胞淋巴瘤

The pegaspargase-based GELOX regimen for treatment of extranodal NK-T-cell lymphoma, nasal type

目的:评价以培门冬酶替代左旋门冬酰胺酶的GELOX方案(吉西他滨、奥沙利铂、培门冬酶)治疗结外鼻型NK/T细胞淋巴瘤的疗效及安全性。方法:回顾分析经病理确诊为鼻型NK/T细胞淋巴瘤患者15例,均接受了4个疗程以上的含有培门冬酶的GELOX方案化疗,即第1、8天静脉滴注吉西他滨1 000mg/(m^2·d),第1天肌肉注射培门冬酶2 500 IU/(m^2·d),第1天静脉滴注奥沙利铂130 mg/(m^2·d),每3周为1个周期。结果:化疗后GELOX完全缓解(CR)率为66.7%,总体有效率(ORR)为100%,2年的无进展生存率为60%,2年的总生存率为80%,GELOX方案毒性反应轻微,除2例患者因肠道浸润,在初次化疗中出现肠穿孔,其他病例无严重不良事件。结论:含有培门冬酶的GELOX方案治疗NK/T细胞淋巴瘤临床疗效好,毒副作用轻,联合局部侵犯放疗后,将有利于患者的远期生存。

Objective To evaluate the safety profile and the efficacy of a pegaspargase-based GELOX regimen （gemcitabine, oxaliplatin and pegaspargase） in patients with nasal-type extranodal natural killer （NK） cell lymphoma （ENKTL）. Methods 15 patients with newly diagnosed ENKTL were treated with more than four cycles of GELOX chemotherapy （gemcitabine 1000 mg/m^2 on dayl and day 8, oxaliplatin 100 mg/m^2 on dayl, pegaspargase 2500 IU/m^2 on dayl and repeated every 3 weeks） are included in the study. Results Upon completion of treatment, the complete response rate （CR） were 66.7% and the overall response rate （ORR） was 100.0% while the 2-year PFS and OS rates were 60% and 80% respectively. The GELOX regimen had been well tolerated in all of patients, and only 2 patients with intestinal tract infiltration suffered enterobrosis during the first induction chemotherapy. Conclusion For patients with newly diagnosed ENKTL, the pegaspargase-based GELOX regimen is a safe and effective treatment, and benefits for long term survival if combined with radiotherapy.