吉西他滨联合环磷酸胺和氟达拉滨治疗非霍奇金淋巴瘤的临床研究

Clinical trial of gemcitabine combined with fludarabine and cyclophosphamide regimen in the treatment of non-Hodgkin lymphoma

目的观察吉西他滨联合环磷酸胺和氟达拉滨治疗非霍奇金淋巴瘤的临床疗效和安全性。方法 64例非霍奇金淋巴瘤患者随机均分为试验组和对照组,每组32例。对照组静脉滴注吉西他滨1000 mg·m^(-2),静脉滴注30 min,每周1次,连续3周,根据患者的药物不良反应相应减少剂量。试验组在对照组的基础上静脉滴注氟达拉滨25 mg·m^(-2),环磷酰胺15 mg·m^(-2),静脉滴注30min,连用5 d。2组均每4周为1个周期,共治疗3个周期。比较2组患者的临床疗效、体能状态评分、疼痛程度及药物不良反应发生情况。结果治疗后,试验组总有效率为96.88%(31/32例),对照组为78.13%(27/32例),差异有统计学意义(P<0.05)。试验组患者治疗前后Kamofsky评分分别为(58.69±4.13),(86.88±3.48)分,差异有统计学意义(P<0.05)。治疗后,试验组和对照组患者的视觉模拟评分(VAS)分别为(1.44±1.21),(4.13±1.36)分,差异有统计学意义(P<0.05)。试验组出现白细胞、血小板减少4例,过敏3例,恶心1例,药物不良反应率为25.00%(8/32例);对照组出现白细胞、血小板减少7例,过敏5例,恶心3例,药物不良反应发生率为46.88%(15/32例),差异有统计学意义(P<0.05)。结论吉西他滨联合环磷酸胺和氟达拉滨治疗非霍奇金淋巴瘤的临床疗效优于单独使用吉西他滨方案,能明显改善患者的体能状态,缓解患者的疼痛。

Objective To investigate the clinical effect of gemcitabine combined with fludarabine and cyclophosphamide regimen in the treatment of non - Hodgkin lymphoma. Methods A total of 64 non- Hodgkin lymphoma patients were randomly divided into treatment group and control group, each group 32 cases. Control group was treated with gemcitabine 1000 mg·m^-2, intravenous infusion for 30 min. Treat- ment group was given fludarabine 25 mg·m^-2, cyelophosphamide 15 mg·m^-2 on the basis of control group, intravenous infusion for 30 min. Four weeks a course, all patients were treated for 3 courses. The clinical efficacy, physical condition score, pain degree and adverse drug reaction in two groups were compared. Results After treatment, total effective rate in treatment group was 96. 88% （31/32 cases）, had significant difference with that in control group, which was 78. 13% （27/32 cases, P 〈0. 05）. Kamofsky scores before and after treatment in treatment group were 58.69±4. 13, 86. 88±3.48, with significant difference（P 〈0. 05）. The visual analogue Scale （VAS） in treatment group and control group after treatment were 1.44±1.21, 4. 13±1.36, with significant difference （P 〈 0.05 ）. There were 4 cases of white blood cells and platelets reduced, 3 cases of allergy, 1 case of nausea in treatment group, the incidence of adverse drug reactions was 25.00% （8/32 cases）. There were 7 cases of white blood cells and platelets reduced, 5 cases of allergy, 3 cases of nausea in control group, the incidence of adverse drug reactions was 46.88% （ 15/32 cases）, with no significant difference （ P 〈 0. 05）. Conclusion The clinical efficacy of gemcitabine combined with fludarabine and cyclophosphamide regimen in the treatment of non - Hodgkin lymphoma is better than single application of gemcitabine. It can not only improve patients＇ physical condition, but also can relieve the pain.