来那度胺、环磷酰胺联合地塞米松方案化疗治疗多发性骨髓瘤的临床效果及安全性分析

Clinical effect and safety analysis of Lenalidomide,Cyclophosphamide combined with Dexamethasone chemotherapy in the treatment of multiple myeloma

目的分析来那度胺、环磷酰胺联合地塞米松(RCD)方案化疗治疗多发性骨髓瘤(MM)的临床效果及安全性。方法选取2016年10月~2018年9月盘锦辽油宝石花医院治疗的65例MM患者,按随机数字表法将其分为观察组(n=33)与对照组(n=32)。对照组接受美法仑、泼尼松、沙利度胺(MPT)方案化疗,观察组接受RCD方案化疗。比较两组的临床疗效、临床指标、不良反应及预后。结果观察组的治疗总有效率(84.85%)、生存率(87.88%)高于对照组(62.50%,59.38%),M-蛋白[(17.42±6.10)g/L]、β2-微球蛋白(β2-MG)[(1.63±0.38)mg/L]及复发率(9.09%)低于对照组(23.57±8.41)g/L、(2.28±0.61)mg/L、(28.13%),差异均有统计学意义(P<0.05);观察组的中性粒细胞减少症(36.36%)、血小板减少症发生率(30.30%)高于对照组(3.13%、3.13%),水肿(6.06%)、嗜睡(3.03%)、便秘发生率(6.06%)低于对照组(28.13%、25.00%、31.25%),差异均有统计学意义(P<0.05)。结论RCD方案化疗用于MM治疗安全可行,能增强MM治疗效果,降低复发率,延长患者生存期,降低非血液学毒性反应。

Objective To analyze the clinical effect and safety of Lenalidomide,Cyclophosphamide combined with Dexamethasone(RCD)chemotherapy in the treatment of multiple myeloma(MM).Methods A total of 65 patients with MM treated in Panjin Liaoyou Baoshihua Hospital from October 2016 to September 2018 were selected and divided into the observation group(n=33)and the control group(n=32)according to random number table method.The control group received Melphalan,Prednisone,and Thalidomide(MPT)regimen chemotherapy,and the observation group received RCD regimen chemotherapy.The clinical efficacy,clinical indicators,adverse reactions and prognosis of the two groups were compared.Results The total effective rate and survival rate of the observation group(84.85%,87.88%)were higher than those of the control group(62.50%,59.38%).The levels of M-protein andβ2-microglobulin(β2-MG)and the recurrence rate of the observation group([17.42±6.10]g/L,[1.63±0.38]mg/L,9.09%)were lower than those of the control group of([23.57±8.41]g/L,[2.28±0.61]mg/L,28.13%),and the differences were statistically significant(P<0.05).The incidence of neutropenia and thrombocytopenia in the observation group(36.36%,30.30%)were higher than those in the control group(3.13%,3.13%),the incidence of edema,drowsiness,and constipation in the observation group(6.06%,3.03%,6.06%)were lower than those in the control group(28.13%,25.00%,31.25%),and the differences were statistically significant(P<0.05).Conclusion RCD chemotherapy is safe and feasible in the treatment of MM,which can enhance the treatment effect of MM,reduce the recurrence rate,prolong the survival time of patients,and reduce the non-hematological toxicity.