环磷酰胺联合VAD方案治疗多发性骨髓瘤24例效果评价

Effective Analysis of Cyclophosphamide Combined with VAD Chemotherapy Regimen in Treating Multiple Myeloma

目的观察环磷酰胺联合VAD(C-VAD)方案治疗多发性骨髓瘤(MM)的临床疗效和不良反应。方法选择MM患者48例,随机分为两组,各24例。C-VAD组采用C-VAD方案治疗;VAD组接受单纯VAD方案治疗。比较两组患者的治疗效果,并按CTCAE 3.0版标准判断用药过程中的不良反应。结果治疗6周期后,C-VAD组患者的各项临床检验指标(瘤细胞百分比、β2-MG、尿液轻链、Scr)明显好于VAD组(P<0.05)。C-VAD治疗组患者总有效率为79.16%(19/24),其中完全缓解(CR)4例(16.67%),非常好的部分缓解(VGPR)6例(25.00%),部分缓解(PR)9例(37.50%),病情稳定(SD)3例(12.50%),病情进展(PD)2例(8.33%)。VAD治疗组患者总有效率为55.00%(11/20),其中CR 1例(4.17%),VGPR 3例(12.50%),PR 7例(29.17%),SD 5例(28.83%),PD 4例(16.67%),两组比较,差异有统计学意义(P<0.05)。两组患者均出现少量不良反应(乏力、胃肠道症状、周围神经病变、不同程度的血小板减少、皮疹及带状疱疹等),两组比较,差异无统计学意义(P>0.05),经对症治疗后均能改善。结论 C-VAD方案治疗多发性骨髓瘤是一种安全、可靠、有效的治疗手段。

Objective To observe the clinical efficacy and adverse reactions of cyclophosphamide combined with VAD(C-VAD) regimen for treating multiple myeloma(MM).Methods Forty-eight patients with MM in our hospital were chosen and randomly divided into two groups,24 cases in each group.The C-VAD group was treated by the C-VAD regimen and the VAD group was treated by the VAD regimen alone.The therapeutical effects were compared between the two groups.The adverse reactions during the treatment process were judged by the standards in the CTCAE 3.0 version.Results The various clinical indexes(oncocytes percentage,β2-MG,urine light chain,Scr) after 6-week therapy in the C-VAD group were significantly better than those in the VAD group(P < 0.05).The total effective rate in the C-VAD group was 79.16%(19 / 24),including 4 cases(16.67%) of CR,6 cases(25.00%) of VGPR,9 cases of PR(37.50%),3 case of SD(12.50%) and 2 cases(8.33%) of PD.The total effective rate in the VAD group was 55.00%(11 /20),including 1 case of CR(4.17%),3 cases(12.50) of VGPR,7 cases(29.17%) of PR,5 cases(28.83%) of SD and 4 cases(16.67%) of PD,the differences between the two groups showed the statistical significance(P < 0.05).There were few adverse reactions occurred in the two groups,including fatigue,gastrointestinal symptoms,peripheral neuropathy,different degrees of thrombocytopenia,skin rash and herpes zoster,which could be improved to some extent after treatment.Conclusion The C-VAD regimen is a safe,reliable and effective treatment measure for MM.