R-CHOP治疗与R-DAEPOCH方案治疗弥漫大B细胞淋巴瘤的近期疗效和毒副作用比较

Comparison of short-term efficacy and toxic and side effects of R-CHOP regimen and R-DAEPOCH regimen in the treatment of diffuse large B-cell lymphoma

目的探讨R-CHOP与R-DAEPOCH方案治疗弥漫性大B细胞淋巴瘤(DLBCL)的近期疗效和毒副作用。方法选取2016年1月至2021年1月广东省人民医院赣州医院收治的62例DLBCL患者作为研究对象,按照随机数字表法分为观察组与对照组,各31例。观察组给予R-DAEPOCH方案治疗,对照组给予R-CHOP方案治疗,比较两组临床疗效、无进展生存期(PFS)、毒副作用发生情况、治疗前后外周血T淋巴细胞(CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+))。结果两组治疗总有效率(ORR)比较差异无统计学意义;观察组4、5、6、9、10、11、12月PFS生存率均高于对照组,差异有统计学意义(P<0.05);两组肝毒性、神经毒性、恶心呕吐发生率比较差异无统计学意义;治疗后,两组CD3^(+)、CD4^(+)水平及CD4^(+)/CD8^(+)与治疗前比较差异无统计学意义,但观察组低于对照组,差异有统计学意义(P<0.05)。结论DLBCL患者治疗中应用R-DAEPOCH方案与R-CHOP方案均可取得良好疗效,R-DAEPOCH方案虽然在保证疗效的同时可在一定程度上延长患者生存时间,然而对免疫功能负面影响相比R-CHOP方案更加明显,可为临床治疗提供一定参考依据。

Objective To explore the short-term efficacy and toxic and side effects of R-CHOP regimen and R-DAEPOCH regimen in the treat-ment of diffuse large B-cell lymphoma(DLBCL).Methods A total of 62 patients with DLBCL admitted to Guangdong Provincial People's Hospital Ganzhou Hospital from January 2016 to January 2021 were selected as the research subjects,and they were divided into the observation group and the control group according to the random number table method,with 31 cases in each group.The observation group was given R-DAEPOCH regi-men,while the control group was given R-CHOP regimen.The clinical efficacy,progression-free survival(PFS),occurrence of toxic and side effects,and peripheral blood T lymphocytes(CD3^(+),CD4^(+),CD4^(+)/CD8^(+))before and after treatment were compared between the two groups.Results There was no significant difference in the overall response rate(ORR)between the two groups;the PFS survival rates of the observation group at 4,5,6,9,10,11 and 12 months were higher than those in the control group,and the differences were statistically significant(P<0.05);there was no significant difference in the incidence of hepatotoxicity,neurotoxicity,nausea and vomiting between the two groups;after treatment,there was no significant dif-ference in the levels of CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)between the two groups before and after treatment,but the observation group was lower than the control group,and the differences were statistically significant(P<0.05).Conclusion Both R-DAEPOCH regimen and R-CHOP regimen can achieve good efficacy in the treatment of patients with DLBCL.Although R-DAEPOCH regimen can prolong the survival time to a certain extent while ensuring the efficacy,its negative effect on immune function is more obvious than that of R-CHOP regimen,which can provide certain refer-ence for clinical treatment.