DHAP方案和GDP方案治疗复发或难治性非霍奇金淋巴瘤的比较研究  

The comparative study of DHAP regimen and GDP regimen in the treatment of relapsed or refractory Non-Hodgkin's lymphoma

作　　者：蔡正文[1] 刘汉锋[1] 甘廷庆[1] 蓝东[1] 

机构地区：[1]广西医科大学第一附属医院肿瘤内科,南宁53021

出　　处：《中国医学文摘（肿瘤学）》2008年第4期349-350,共2页Journal of Chinese Medical Abstracts·Oncology

摘　　要：目的观察和评价DHAP(顺铂、阿糖胞苷、地塞米松)和GDP(吉西他滨、顺铂、地塞米松)方案治疗复发、难治性非霍奇金淋巴瘤(Non-Hodgkin lymphoma,NHL)的疗效及毒副反应。方法 45例复发、难治性NHL患者随机分成两组:DHAP方案组21例,采用顺铂、阿糖胞苷、地塞米松联合化疗;GDP方案组2 4例,采用吉西他滨、顺铂、地塞米松联合化疗,化疗2周期后评价疗效和毒副反应。结果全部患者均可评价疗效和毒副反应。DHAP组:完全缓解(CR)5例(2 3.8%),部分缓解(PR)9例(42.9%),稳定(SD)5例(2 3.8%),进展或恶化(PD)2例(9.5%),总缓解率(CR+PR)6 6.7%;GDP组:CR 4例(1 6.7%),PR 1 0例(41.7%),SD 7例(2 9.2%),PD 3例(1 2.5%),总缓解率(CR+PR)5 8.3%,总缓解率两组比较差异无统计学意义(P>0.0 5)。主要毒副反应为消化道反应和骨髓抑制,患者均可耐受。消化道反应和白细胞减少两组比较差异无统计学意义(P>0.0 5);血小板减少DHAP组明显高于GDP组(P<0.0 5)。结论DHAP和GDP方案治疗复发、难治性NHL的总缓解率相似,毒副反应均可耐受,DHAP方案血小板减少比GDP方案更明显。Objective To evaluate the efficacy and toxicity of DHAP regimen（cytarabine,cisplatin and dexamethasone） and GDP regimen（gemcitabine,cisplatin and dexamethasone）in the treatment of relapsed or refractory non-Hodgkin＇s lymphoma. Methods Forty-five patients with relapsed or refractory non-Hodgkin＇s lymphoma were randomized into two groups. Group DHAP included 21 cases and was treated with cytarabine plus cisplatin, dexamethasone. Group GDP included 24 cases and was treated with gemcitabine plus cisplatin, dexamethasone The evaluation of efficacy and to：dcity was performed alter 2 cycles of chemotherapy given. Results All patients were evaluated for the efficacy and toxicity. There were 5 complete responses（CR,23. 8%） and 9 partial responses（PR,42. 9%） in the group DHAP versus 4 complete responses（CR,16. 7%） and 10 partial responses（PR,41.7%） in the group GDP. The overall response rates were 66. 7% in the group DHAP and 58. 3% in the group GDP. The difference of the overall response rates between two groups was insignificant（P〉0. 05）. The most common toxicities were digestive tract responded,leucopertia and thrombocytopenia,but all patients were relatively well tolerated. Digestive tract responded and leucopenia there were no statistical diffevence（P〉0. 05）. The incidence rate of thrombocytopenia in group DHAP was higher than those in group GDP（P〈0. 05）. Conclusion The efficacy of DHAP regimen is similar to that of GDP regimen in the treatment of relapsed or refractory non-Hodgkin＇s lymphoma,but thromboeytopenia in group DHAP was higher than those in group GDP.

关 键 词：淋巴瘤 非霍奇金/药物疗法 抗肿瘤联合化疗方案 DHAP方案 GDP方案 

分 类 号：R733.1[医药卫生—肿瘤] R521[医药卫生—临床医学]