P-CTD化疗方案与CTD化疗方案治疗老年难治性多发性骨髓瘤的疗效对比

Comparison between P-CTD chemotherapy regimen and CTD chemotherapy regimen in the treatment of senile refractory multiple myeloma

目的分析P-CTD化疗方案与CTD化疗方案治疗老年难治性多发性骨髓瘤的疗效。方法选取63例老年难治性多发性骨髓瘤患者作为研究对象。按化药方案不同分为两组,采用P-CTD化疗方案者33例(P-CTD组)采用CTD化疗方案者30例(CTD组)。患者的观察并比较两组临床疗效、M蛋白含量、骨髓细胞含量、β_(2)微球蛋白(β_(2)-MG)和血红蛋白(Hb)水平及不良反应发生情况。结果P-CTD组总有效率为93.94%,明显高于CTD组(56.67%),差异有统计学意义(χ^(2) =7.47,P<0.05);与化疗前比较,两组患者化疗后M蛋白含量、骨髓细胞含量和β_(2)-MG水平下降,Hb水平升高(t分别=10.13、9.94、29.66、-14.39;6.39、3.42、18.81、-6.28,P均<0.05),且P-CTD组治疗后M蛋白含量、骨髓细胞含量、β_(2)-MG低于CTD组,Hb水平高于CTD组(t分别=4.97、9.67、11.56、-7.21,P<0.05);两组不良反应发生情况比较,差异无统计学意义(χ^(2) =0.64,P>0.05)。结论P-CTD化疗方案应用于老年难治性多发性骨髓瘤,临床疗效和对M蛋白含量、骨髓细胞含量、β_(2)-MG和Hb水平的改善作用均优于CTD化疗方案,且不良反应并不多于CTD化疗方案。

Objective To analyze the efficacy of P-CTD chemotherapy regimen and CTD chemotherapy regimen in the treatment of senile refractory multiple myeloma.Methods Sixty-three elderly patients with refractory multiple myeloma were selected as subjects and divided into two groups according to different chemotherapeutic regimen.There were 33 patients receiving P-CTD chemotherapy regimen(P-CTD group)adn 30 patients receiving CTD chemotherapy regimen(CTD group).The clinical efficacy,M protein content,bone marrow cell content,β_(2) microglobulin(β_(2)-MG)and hemoglobin(Hb)levels and the occurrence of adverse reactions were observed and compared between the two groups.Results The total effective rate was 93.94%in P-CTD group,which was higher than 56.67%in CTD group(χ^(2) =7.47,P<0.05).Compared with before chemotherapy,M protein content,bone marrow cell content andβ_(2)-MG level in two groups were decreased after chemotherapy,while Hb level was increased(t=10.13,9.94,29.66,-14.39,6.39,3.42,18.81,-6.28,P<0.05),and the content of M protein,bone marrow cell andβ_(2)-MG in P-CTD group were lower than those in CTD group,while the level of Hb was higher than that in CTD group(t=4.97,9.67,11.56,-7.21,P<0.05).There was no difference in the incidence of adverse reactions between the two groups(χ^(2) =0.64,P>0.05).Conclusion The clinical efficacy and improvement effect of P-CTD chemotherapy on M protein content,bone marrow cell content,β_(2)-MG and Hb levels in patients with refractory multiple myeloma are better than CTD chemotherapy,and the adverse reactions are not more serious than CTD chemotherapy.