复方斑蝥胶囊联合化疗治疗弥漫大B细胞淋巴瘤的临床研究

Clinical study on treatment of diffuse large B-cell lymphoma with compound cantharidis capsule combined with chemotherapy

目的探讨复方斑蝥胶囊联合环磷酰胺+表柔比星+长春新碱+泼尼松(CHOP方案)治疗弥漫大B细胞淋巴瘤(DLBCL)的临床疗效。方法回顾性分析73例DLBCL患者的临床资料,根据治疗方法的不同将患者分为复方斑蝥胶囊联合CHOP组(n=37)和CHOP组(n=36),比较两组患者的临床有效率、生存率、无进展生存率和不良反应发生率。结果治疗后复方斑蝥胶囊联合CHOP组中,完全缓解(CR)21例,部分缓解(PR)10例,总有效率为83.8%(31/37);CHOP组中,CR 15例,PR 7例,总有效率为61.1%(22/36),两组患者的总有效率比较,差异有统计学意义(P﹤0.05)。对于国际预后指数(IPI)评分为3~5分、Ki-67≥80%及β2微球蛋白升高的患者,复方斑蝥胶囊联合CHOP组的有效率分别为85.7%、90.5%和90.0%,均高于CHOP组的55.0%、61.9%和57.1%,差异均有统计学意义(P﹤0.05)。两组患者的1年总生存率、1年无进展生存率及不良反应发生率比较,差异均无统计学意义(P﹥0.05)。结论复方斑蝥胶囊联合CHOP方案治疗DLBCL的临床有效率高于CHOP方案,且不良反应无明显增多,值得临床推广应用。

Objective To observe the clinical efficacy of compound cantharidis capsule combined with cyclophosphamide ＋ epirubicin ＋ vincristin ＋ prednisone（CHOP regimen） in the treatment of diffuse large B-cell lymphoma（DLBCL）.Method The clinical data of 73 patients with DLBCL were analyzed retrospectively. According to the different treatment methods, the patients were divided into compound cantharidis capsule combined with CHOP group（n=37） and CHOP group（n=36）. The clinical effective rates, survival rates, progression-free survival rates and incidences of adverse reactions were compared between the two groups. Result In compound cantharidis capsule combined with CHOP group, complete remission（CR） was observed in 21 cases, partial remission（PR） was observed in 10 cases, the total effective rate was 83.8%（31/37）; in CHOP group, CR was observed in 15 cases, PR was observed in 7 cases, the total effective rate was 61.1%（22/36）, the difference of total effective rates between two groups was statistically significant（P〈0.05）. For the patients with the international prognostic index（IPI） score of 3-5, Ki-67≥80% or increased β2-MG, the effective rates of the compound cantharidis capsule combined with CHOP group was 85.7%, 90.5% and 90.0% respectively, which were all significantly higher than those in the CHOP group of 55.0%, 61.9% and 57.1%（P〈0.05）. There was no significant difference in one-year overall survival rate, one-year progression-free survival rate and incidence of adverse reactions between the two groups（P〈0.05）. Conclusion The clinical curative effect of compound cantharidis capsule combined with CHOP regimen in the treatment of DLBCL is better than that of CHOP, and there is no significant increase in adverse reactions.