PD与VAD方案对多发性骨髓瘤的疗效比较  

Comparative Efficacy of PD and VAD Regimens for Multiple Myeloma

作　　者：赵瑜[1] 靖域[1] 薄剑[1] 王书红[1] 李红华[1] 黄文荣[1] 朱海燕[1] 韩晓萍[1] 高春记[1] 于力[1] 

机构地区：[1]解放军总医院血液科,北京100853

出　　处：《中国实验血液学杂志》2010年第3期652-654,共3页Journal of Experimental Hematology

摘　　要：本研究评价PD(硼替佐米、地塞米松)和VAD(长春新碱、阿霉素、地塞米松)两种方案对多发性骨髓瘤的疗效和毒副作用。分别有21和31例多发性骨髓瘤患者纳入PD和VAD治疗组,接受2-5个疗程治疗。所有52例患者中,48例为初治患者,4例曾应用过1-2个疗程M2或MP方案化疗,但未达到部分缓解。在PD组中,完成2、3、4、5个疗程的患者分别为4、4、8、5例;在VAD组中完成2、3、4、5个疗程的患者分别为6、11、12、2例。结果表明:两组患者的反应良好(CR和VGPR)的患者比例在PD组明显高于VAD组,分别为57.1%和16.1%,差异有显著性意义(p=0.0052)。治疗有效(CR、VGPR和PR)的患者比例在PD和VAD两组中分别为95.2%和74.2%,差异无显著性意义(p=0.1108)。PD组所有患者无1例出现疾病进展,VAD组中有1例疾病进展。两组患者在血液学毒性、肝肾功能损害、周围神经病变、感染、间质性肺炎等主要不良反应发生率相似,差异无统计学意义。结论:与传统的一线治疗方案VAD相比,PD可提高多发性骨髓瘤治疗反应良好的比例,且不增加副反应发生率。This study was aimed to compare the efficacy and adverse effects of PD （bortezomib ＋ dexamethasone） and VAD （ vincristine ＋ adriamycin ＋ dexamethasone） as regimens for treatment of multiple myeloma patients. 21 and 31 multiple myeloma patients were enrolled in the PD and VAD groups respectively which received 2 to 5 courses of treatments, and both clinical effects and adverse reactions were observed. In the all 52 patients, 48 were newly diagnosed and the other 4 patients had accepted 1 to 2 courses of M2 or MP treatment, but didn＇t get PR. In 52 patients, 4, 4, 8 and 5 patients accepted 2, 3, 4 and 5 courses of PD regimen respectively, while 6, 11, 12 and 2 patients accepted 2, 3, 4 and 5 courses of VAD regimen respectively. The results indicated that the rate of good efficacy （ both CR and VGPR ） in PD group was 57. 1%, while the rate of good efficacy in VAD group was 16.1%, there was significant difference （p = 0.0052）. The percentage of patients who got CR, VGPR and PR in PD and VAD groups were 95.2% and 74.2% respectively, there was no significant difference （p = 0.1108）. The incidences of adverse effects in 2 groups were similar, which included hematological toxicity, liver and kidney functional lesion, peripheral neuropathy, infection, interstitial pneumonia. It is concluded that compared with conventional VAD chemotherapy, PD may improve CR and VGPR rate in newly diagnosed patients with multiple myeloma, meanwhile it does not bring about more and worse toxicity.

关 键 词：PD方案 VAD方案 多发性骨髓病 

分 类 号：R733.3[医药卫生—肿瘤] R979.1[医药卫生—临床医学]