VSMCD方案治疗多发性骨髓瘤的临床研究

Treatment of multiple myeloma with VSMCD regimen

目的 评价VSMCD(Vincristine ,semustine ,melphalan ,cyclophosphamide ,desamethasone)方案治疗多发性骨髓瘤(MM)的临床效果。方法 应用临床实验研究方法 ,按入院顺序采用半随机分组法将病例分成试验组与对照组 ,试验组采用VSMCD治疗方案 ,对照组采用改良M2 治疗方案。治疗观察 4个疗程后进行近期疗效评价。结果 试验组与对照组治疗的有效率分别为 91.66%及 5 8.3 3 % ,两组有极显著性差异 (P <0 .0 1)。两种方案治疗后VSMCD法各项临床疗效指标变化较改良M2 法变化大 ,两种方案有极显著性差异 (P <0 .0 1) ;主要毒副作用的比较除WBC降低 (P <0 .0 1)及急性粘膜炎(P <0 .0 5 )差异有显著性外 ,其余差异均无显著性 ;VSMCD法治疗未见肾功能损伤 ,未见永久性造血干细胞损害和治疗相关性死亡。结论 VSMCD方案治疗多发性骨髓瘤疗程短 ,疗效高 ,副作用持续时间短暂。

Objective To evaluate the clinical effects of vincristine, semustine, melphalan, cyclophosphamide, desamethasone (VSMCD) regimen for the treatment of multiple myeloma(MM). Methods Cases were semi randomly divided into two groups. The experimental group received VSMCD regimen and the control received improved M 2 regimen. The curative effects were observed after four treatment courses. Results The effective rates of the experimental group and the control group were 91.66% and 58.33%, respectively. There was significant difference between the two groups( P <0.01). The clinical curative effect indexes of the patients of the experimental group changed more significantly than those of the control group ( P <0.05). No significant difference in side effects was found between the two groups except the decreases in WBC( P <0.01) and acute mucositis( P <0.05). No renal function damage, permanent hemopoietic stem cellular defection and treatment related death were found in the experimental group. Conclusion Treatment of multiple myeloma with the VSMCD regimen is characterized by short treatment course, high curative effect and transient side effects.