PAD与VAD治疗老年多发性骨髓瘤的临床效果比较

Clinical efficacy of PAD and VAD regimens in patients with elderly multiple myeloma

目的探讨硼替佐米+脂质体阿霉素+地塞米松(PAD)方案与长春新碱+脂质体阿霉素+地塞米松(VAD)方案治疗老年多发性骨髓瘤(MM)患者的临床疗效。方法选取内蒙古医科大学附属医院2015年5月至2017年5月收治的36例老年MM患者作为研究对象,依据治疗方案不同分为PAD组(20例)和VAD组(16例)。根据国际骨髓瘤工作组(IMWG)发布的疗效评价标准评价疗效,根据美国国立癌症研究院不良事件通用名(NCI CTCAE)v 3.0判断不良反应。结果 PAD组患者的总有效率(ORR)及完全缓解率(CR)均明显高于VAD组,差异均有统计学意义(均P<0.05)。PAD组患者血液学不良反应、胃肠道不良反应、周围神经炎及乏力发生率均明显低于VAD组,差异均有统计学意义(均P<0.05)。结论 PAD方案对老年MM患者疗效较好,不良反应较轻,优于VAD方案。

Objective The purpose of this study was to investigate the efficacy and safety of PAD and VAD regimen S in the treatment of patients with elderly multiple myeloma.Methods From May 2015 to May 2017,36 elderly patients with MM were selected from the Affiliated Hospital of Inner Mongolia Medical University as the research objects.They were divided into PAD group（20 cases） and VAD group（16 cases） according to the treatment plan.The efficacy was evaluated according to the efficacy evaluation criteria published by the International Myeloma Working Group,and adverse events were assessed according to the National Cancer Institute Common Terminology Criteria for Adverse Event.Results The total effective rate and complete remission rate in group PAD were significantly higher than that in group VAD（P〈0.05）.The incidence of hematological adverse reactions, gastrointestinal adverse reactions,peripheral neuritis and fatigue in group PAD were significantly lower than those in group VAD（P〈0.05）.Conclusion PAD program for elderly patients with myeloma better efficacy,less adverse reactions,better than the VAD program.