CTOP与CHOP方案治疗初治侵袭性非霍奇金淋巴瘤患者疗效分析——一项前瞻、开放、随机、多中心临床研究  

Treatment outcome analysis of CTOP or CHOP regimen in newly diagnosed aggressive non-Hodgkin＇s lymphoma patients--results of a prospective,open,randomized,multicenter clinical trial

作　　者：王彦艳[1] 张晋林[2] 王椿[3] 王欣[4] 吴德沛[5] 梁辉[6] 朱军[7] 李军民[1] 沈志祥[1] 

机构地区：[1]上海血液学研究所、上海交通大学医学院附属瑞金医院,200025 [2]四川省人民医院 [3]上海市第一人民医院 [4]山东省立医院 [5]苏州大学附属第一医院 [6]上海市新华医院 [7]北京肿瘤医院

出　　处：《中华血液学杂志》2010年第10期649-653,共5页Chinese Journal of Hematology

摘　　要：目的 比较CTOP与CHOP方案治疗初治侵袭性非霍奇金淋巴瘤患者疗效与不良反应.方法 2006年10月至2009年6月,全国72家单位共入组196例患者,随机分入CTOP与CHOP组,比较两组疗效与不良反应.结果 196例患者中可评价154例,CTOP组105例,CHOP组49例,比例1.93∶1,在方案设定的2∶1范围内.CTOP组完全缓解（CR）率73.3%,总有效（RR）率87.6%;CHOP组CR率71.4%,RR率86.2%,两组间比较差异无统计学意义.对于不同亚型,B细胞淋巴瘤患者CTOP与CHOP疗效没有差异;而T细胞淋巴瘤患者CTOP组CR率（71.1%）明显高于CHOP组（58.8%）,两者差异有统计学意义.血液学毒性、胃肠道反应、肝肾功能异常两组间均没有差异,而CTOP组患者3、4度脱发（12.4%）显著少于CHOP组（40.8%）,差异有统计学意义.无进展生存（PFS）和总体生存（OS）随访后显示CTOP组1、2、3年的PFS率和OS率分别为79.0%、64.8%、51.4%及82.9%、70.5%、58.1%;CTOP组1、2、3年的PFS率和OS率分别为77.6%、61.2%、49.0%及81.6%、67.3%、55.1%.结论 CTOP方案治疗初治NHL患者疗效与CHOP相当,不良反应较少.对于T细胞淋巴瘤,CTOP方案显示较好疗效.Objective To compare the efficacy and toxicity of CTOP and CHOP regimen for newly diagnosed aggressive non-Hodgkin＇s lymphoma（NHL）patients.Method From Oct 2006 to Jun 2009,196 patients enrolled into this clinical trial from 72 centers in China were randomized into CTOP or CHOP group.Results Of 154 patients evaluated,105 assigned in CTOP group and 49 in CHOP.Complete remission （CR）rate was 73.3%,and response rate（RR）was 87.6% in CTOP group and CR rate 71.4%,RR 86.2% in CHOP group,respectively（both P〉0.05）.For B cell lymphomas,there was no difference in outcome between the two groups,but for T cell lymphomas,CR was 71.1% in CHOP,being significantly higher than that of 58.8% in CHOP group.There was no difference in hematological toxicity,GI reaction,liver and kidney function abnormality,but the occurrence of grade 3-4 alopecia in CTOP group（12.4%）was significantly lower than that in CHOP group（40.8%）.The progress-free survival and overall survival（PFS and OS）at 1-,2-,3-year in CTOP group were 79%,64.8%,51.4% and 82.9%,70.5%,58.1% respectively;while in CTOP group were 77.6%,61.2%,49% and 81.6%,67.3%,55.1% respectively.Conclusion CTOP regimen has similar effectiveness to CHOP regimen in newly diagnosed aggressive NHL,but with less side effects,and better efficacy for T cell lymphomas.

关 键 词：吡柔比星 淋巴瘤 非霍奇金 治疗效果 不良反应 疾病无进展生存 总体生存 

分 类 号：R686[医药卫生—骨科学]