美罗华联合CHOP方案治疗侵袭性B细胞淋巴瘤45例临床疗效观察  

Effect of Rituximab in Combination with CHOP Chemotherapy on 45 Aggressive B-cell Lymphoma Cases

作　　者：双跃荣[1] 叶大茜[1] 陈建祥[1] 吴耀华[1] 黄晖[1] 樊光华[1] 

机构地区：[1]江西省肿瘤医院肿瘤内科,南昌市330029

出　　处：《中国肿瘤临床》2007年第24期1414-1417,共4页Chinese Journal of Clinical Oncology

摘　　要：目的:观察美罗华(利妥昔单抗,Rituximab)联合CHOP(RCHOP)方案治疗侵袭性B细胞非霍奇金淋巴瘤的临床疗效、不良反应。方法:45例CD20阳性的B细胞非霍奇金淋巴瘤患者,随机分为RCHOP组(22例)和CHOP对照组(23例),分别采用美罗华联合CHOP和单用CHOP方案治疗。CHOP方案:环磷酰胺750mg/m2,静脉注射,d1;吡喃阿霉素40mg/m2或表阿霉素60mg/m2,静脉注射,d1;长春新碱1.4mg/m2,静脉注射,d1;强的松100mg,口服,d1～d5,每21天为1个周期、重复治疗。RCHOP方案:美罗华375mg/m2,静脉滴注,每1个周期第1天(d1);第3天开始CHOP方案,每21天为1个周期,重复治疗。全部45例患者完成4个周期化疗后进行疗效评价,随访观察生存情况。结果:RCHOP组完全缓解率(CR)为68.2%,总有效率为81.8%;CHOP组分别为34.8%、78.3%,两组CR率有显著性差异(P<0.05)。RCHOP组1年总生存率(OS)为90.9%,2年OS为81.8%,3年OS为77.3%;CHOP组分别为91.3%、69.5%、47.8%;两组患者的3年OS有显著性差异(P<0.05)。两组患者不良反应主要为轻中度骨髓抑制和胃肠道反应,不良反应发生率相近(P>0.05),均可耐受。RCHOP组6例(27.2%)出现美罗华输注相关的不良反应,经对症处理后好转。结论:美罗华联合CHOP(RCHOP)方案治疗侵袭性B细胞非霍奇金淋巴瘤疗效显著,患者耐受良好,应推荐作为首选方案。Objective： To evaluate the efficacy and toxicity of combination chemotherapy consisting of Rituximab and CHOP （R-CHOP） in patients with aggressive B-cell non-Hodgkin＇s lymphoma. Methods： A total of 45 patients with histopathologically proven CD20-positive B-cell non-Hodgkin＇s lymphoma were randomly assigned into the R-CHOP group （22 patients） and the CHOP group （23 patients）. CHOP regimen： Cyclophosphamide 750 mg/m^2 Ⅳ, Vincristine 1.4 mg/m^2 Ⅳ, and Epirubicin 60 mg/m^2 or Pirarubicin 40 mg/m^2 Ⅳ were administered on the first day of the chemotherapy course; Prednisone 100 mg/m^2 was administered orally from the first day to the fifth day; the cycle was repeated every 21 days. R-CHOP regimen： Rituximab 375 mg/mg^2 was infused on the first day, CHOP was administered starting on the third day. All of the patients have received at least 4 chemotherapy cycles. The therapeutic effect was assessed. All patients were followed up. Results： The complete response rate and overall response rate were 68.2% and 81.8%, respectively, in the R-CHOP group, and 34.8% and 78. 3%, respectively, in the CHOP group. The complete response rate in the R-CHOP group was significantly higher than that in the CHOP group （P〈0.05）. The 1-, 2- and 3- year survival rates were 90. 9%, 81.8%, and 77.3%, respectively, in the R-CHOP group and 91.3%, 69.5%, and 47.8%, respectively, in the CHOP group. The 3-year survival rate was significantly higher in the R-CHOP group than in the CHOP group （P〈0.05）. The major side effects in the two groups were mild to moderate myelosup-pression and gastrointestinal toxicity, without a significant difference between the two groups （P〉0.05）. Rituximab infusion-induced adverse effects occurred in 6 patients （27.2%） in the R-CHOP group. Conclusion： Combination chemotherapy including Rituximab and CHOP （R-CHOP） is recommended as the preferred treatment for B-cell non-Hodgkin＇s lymphoma because it is effective and well-tolerated by the patients.

关 键 词：B细胞非霍奇金淋巴瘤 美罗华 化疗 

分 类 号：R733.1[医药卫生—肿瘤]