硼替佐米每周一次用药方案治疗初治多发性骨髓瘤效果观察

Efficacy observation of bortezomib once-weekly therapy for newly diagnosed multiple myeloma

目的观察硼替佐米每周1次用药方案治疗初治多发性骨髓瘤患者的临床效果及不良反应。方法回顾性分析2016年6月至2019年6月山东省菏泽市立医院50例接受以硼替佐米为基础联合化疗方案治疗的初治多发性骨髓瘤患者的临床资料,根据用药频次不同分为每周1次用药方案组(观察组,21例)及每周2次用药方案组(对照组,29例),比较两组患者的疗效和不良反应。结果观察组前2个疗程总有效率为23.8%(5/21),低于对照组的55.2%(16/29),差异有统计学意义(χ^2=4.918,P=0.027);治疗4、6个疗程后,观察组与对照组总有效率差异均无统计学意义[66.7%(14/21)比72.4%(21/29),81.0%(17/21)比86.2%(25/29),均P>0.05]。观察组周围神经病变发生率为14.3%(3/21),低于对照组的41.4%(12/29),差异有统计学意义(χ^2=4.416,P=0.036);两组其他不良反应发生率差异均无统计学意义(均P>0.05)。结论硼替佐米每周1次用药方案治疗初治多发性骨髓瘤的效果与每周2次用药方案相似,且周围神经病变发生率更低,患者耐受性更好。

Objective To observe the clinical efficacy and adverse reactions of bortezomib once-weekly therapy for newly diagnosed multiple myeloma(MM).Methods The clinical data of 50 patients with newly diagnosed MM who received bortezomib combined with chemotherapy in Heze Municipal Hospital of Shandong Province from June 2016 to June 2019 were retrospectively analyzed.The patients were divided into once-weekly medication regimen(the observation group,21 cases)and twice-weekly medication regimen(the control group,29 cases).The efficacy and adverse reactions of both groups were compared.Results The total effective rate of the former 2 treatment courses in the observation group was lower than that in the control group,and the difference was statistically significant[23.8%(5/21)vs.55.2%(16/29),χ^2=4.918,P=0.027].After treatment of 4 and 6 courses,there were no statistically significant differences in the total effective rate between the observation group and the control group[66.7%(14/21)vs.72.4%(21/29);81.0%(17/21)vs.86.2%(25/29),all P>0.05].The incidence of peripheral neuropathy in the observation group was lower than that in the control group,and the difference was statistically significant[14.3%(3/21)vs.41.4%(12/29),χ^2=4.416,P=0.036].There was no statistically significant difference in the incidence of other adverse reactions of both groups(both P<0.05).Conclusions The therapeutic effect of once-weekly medication regimen is similar to that of twice-weekly medication regimen for the treatment of newly diagnosed MM.The incidence of peripheral neuropathy in the once-weekly therapy is low and the patients can have better tolerance.