沙利度胺联合CHOP方案治疗外周T细胞淋巴瘤的临床研究

Clinical study on thalidomide combined with CHOP regimen in treatment of lymphoma peripheral T cell

目的探究沙利度胺片联合CHOP方案治疗外周T细胞淋巴瘤的临床疗效。方法选取2015年9月—2016年9月郑州颐和医院收治的外周T细胞淋巴瘤患者53例,按照随机数表法随机分为对照组(27例)和治疗组(26例)。对照组给予CHOP方案治疗:第1天静脉注射注射用环磷酰胺750 mg/m^2;注射用硫酸长春新碱1.4 mg/m^2;盐酸表柔比星注射液50 mg/m^2;同时第1~5天口服醋酸泼尼松片,10 mg/d。治疗组在对照组基础上口服沙利度胺片,起始剂量为50 mg/次,2次/d,每周剂量增加50 mg/次直至200 mg/次。两组均以21 d为1个疗程,共治疗8个疗程。观察两组的临床疗效,比较两组的精氨酸酶1(Arg-1)、血管内皮生长因子(VEGF)、诱生型一氧化氮合成酶(iNOS)水平和不良反应情况。结果治疗后,对照组和治疗组的总有效率分别为62.96%、84.62%,两组比较差异有统计学意义(P<0.05)。治疗后,治疗组Arg-1、VEGF、iNOS水平均显著下降,同组治疗前后比较差异有统计学意义(P<0.05);且治疗组这些观察指标的下降程度明显优于对照组,两组比较差异具有统计学意义(P<0.05)。对照组和治疗组骨髓抑制发生率分别为55.56%、19.23%,胃肠道不良反应发生率分别为59.26%、19.23%,肝脏损害发生率分别为37.03%、26.92%,两组比较差异具有统计学意义(P<0.05)。结论沙利度胺片联合CHOP方案治疗外周T细胞淋巴瘤具有较好的临床疗效,可降低Arg-1、VEGF、iNOS水平,安全性较好,具有一定的临床推广应用价值。

Objective To investigate the clinical effect of Thalidomide Tablets combined with CHOP regimen in treatment of lymphoma peripheral T cell. Methods Patients（53 cases） with lymphoma peripheral T cell in Zhengzhou Yihe Hospital Affiliated to Henan University from September 2015 to September 2016 were randomly divided into the control group（27 cases） and the treatment group（26 cases） according to the random number table method. Patients in the control group were given CHOP regimen. Patients in the control group were iv administered with Ifosfamide for injection 750 mg/m^2 at the first day. Patients in the control group were iv administered with Vincristine Sulfate for injection 1.4 mg/m^2 at the first day. Patients in the control group were iv administered with Epirubicin Hydrochloride Injection for injection 50 mg/m^2 at the first day. And Patients in the control group were po administered with Prednisone Acetate Tablets 10 mg/d on day 1 — 5. Patients in the treatment group were po administered with Thalidomide Tablets on the basis of the control group, starting dosage 50 mg/time, increase of 50 mg/time weekly until 200 mg/time. A course of treatment was 21 d in two groups, treatment of 8 courses. After treatment, the clinical efficacies were evaluated, and Arg-1, VEGF, i NOS levels, and adverse reactions in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 62.96% and 84.62%, respectively, and there was difference between two groups（P〈0.05）. After treatment, the levels of Arg-1, VEGF, iNOS in two groups were significantly decreased, and the difference was statistically significant in the same group（P〈0.05）. And the observational indexes in the treatment group were significantly lower than those in the control group, with significant difference between two groups（P〈0.05）. The incidence of bone marrow suppression in the control and treatment groups were 55.56% and 19.23%, respectively. The incidence of gastrointestinal reactions in the control and treatment groups were 59.26% and 19.23%, respectively. The incidence of liver damage in the control and treatment groups were 37.03% and 26.92%, respectively, and there was difference between two groups（P〈0.05）. Conclusion Thalidomide Tablets combined with CHOP regimen has clinical curative effect in treatment of lymphoma peripheral T cell, can decrease the levels of Arg-1, VEGF, and iNOS, with good safety, which has a certain clinical application value.