含硼替佐米化疗的两种方案治疗初治多发性骨髓瘤疗效及对患者总生存期和毒副反应的影响

The curative effect of BCD and BAD regimens of bortezomib-contained chemotherapy in the treatment of newly diagnosed multiple myeloma and their influences on overall survival and toxic side effects

目的探讨含硼替佐米化疗的两种方案治疗初治多发性骨髓瘤疗效及对患者总生存期和毒副反应的影响。方法回顾性分析收治的初治多发性骨髓瘤患者107例,其中75例行BCD方案化疗(BCD组,硼替佐米+环磷酰胺+地塞米松),32例行BAD化疗方案(BAD组,硼替佐米+阿霉素+地塞米松);分析两组治疗有效率、生存情况及不良反应情况。结果BAD组治疗总有效率为96.88%,显著高于BCD组(P<0.05);BAD组治疗后KPS评分为(86.45±13.18)分,显著高于BCD组(P<0.05);两组治疗后不良反应发生率比较,差异无统计学意义(P>0.05);随访至2019年1月31日,BCD组3年无进展生存率为21.33%(16/75),中位PFS为12.6个月;3年总生存率为77.33%(58/75)。BAD组3年无进展生存率为37.50%(12/32),中位PFS为19.2个月;3年总生存率为81.25%(26/32)。两组3年无进展生存率和总生存率比较,差异无统计学意义(P>0.05)。结论BAD方案治疗初治多发性骨髓瘤疗效较好,可有效改善患者生存质量,效果优于BCD方案;但含硼替佐米化疗方案的神经毒性作用较大,治疗过程中应结合患者自身情况慎重用药。

Objective To explore the curative effect of BCD and BAD regimens of bortezomib-contained chemotherapy in the treatment of newly diagnosed multiple myeloma and their influences on overall survival and toxic side effects.Methods A retrospective analysis was performed on 107 patients newly diagnosed with multiple myeloma admitted in our hospital.Of the 107 patients,75 underwent BCD chemotherapy regimen(BCD group,bortezomib,cyclophosphamide and dexamethasone),and 32 underwent BAD chemotherapy regimen(BAD group,bortezomib,adriamycin and dexamethasone).The response rate of treatment,survival conditions and adverse reactions in both groups were analyzed.Results The total response rate of the treatment in the BAD group was 96.88%that was significantly higher than that in the BCD group(P<0.05).After treatment,KPS score in the BAD group was 86.45±13.18 points that were significantly higher than that in BCD group(P<0.05).There was no significant difference in incidence of adverse reactions after treatment between the two groups(P>0.05).The patients were followed-up until to January 31,2019.The 3-year progression-free survival(PFS)rate,median PFS and 3-year overall survival rate in the BCD group were 21.33%(16/75),12.6 months and 77.33%(58/75),respectively.The above indexes in the BAD group were 37.50%(12/32),19.2 months and 81.25%(26/32),respectively.There was no significant difference in 3-year progression-free survival rate or overall survival rate between the two groups(P>0.05).Conclusion The curative effect of BAD regimen is relatively better in the treatment of newly diagnosed multiple myeloma.BAD regimen can effectively improve the quality of life of patients and the effect is better than that of BCD.However,neurotoxicity effect of bortezomib-contained chemotherapy regimen is greater.In the treatment process,patient's own conditions should be combined to conduct medicine carefully.