早期结外鼻型NK/T细胞淋巴瘤GDL方案治疗的临床观察  

Clinical observation of combined chemotherapy with gemcitabine,dexamethasone and l-asparaginase on early stage extranodal nasal type NK/T-cell lymphoma

作　　者：赵燕伟[1] 薛宏伟[1] 李美林[2] 肖一平[2] 朱静娟[1] 张克[2] 宋成村[1] 

机构地区：[1]青岛大学医学院附属医院肿瘤科,山东青岛266003 [2]青岛大学医学院附属商业医院内科,山东青岛266011

出　　处：《中华肿瘤防治杂志》2012年第15期1187-1190,共4页Chinese Journal of Cancer Prevention and Treatment

摘　　要：目的:评价吉西他滨、地塞米松和左旋门冬酰胺酶组成的GDL方案对结外鼻型NK/T细胞淋巴瘤的疗效和毒副作用。方法:GDL方案:盐酸吉西他滨1 000mg/m2加入生理盐水100mL中,静脉滴入,d1、d8;地塞米松10mg/m2,静脉滴入,d1～d5;左旋门冬酰胺酶5 000U/m2加入5%葡萄糖250mL中,静脉滴入,d1～d7,21d为1个周期。全组48例患者接受4个周期化疗后评价疗效,3周后行累及野放射治疗后。结果:完全缓解(CR)率为54.2%(26/48),部分缓解(PR)率为35.4%(17/48),疾病稳定(SD)率为8.3%(4/48),疾病进展(PD)率为2.1%(1/48),经放射治疗后全组CR率91.7%(44/48),PR率为8.3%(4/48),有效率100%。中位随访36(10～58)个月,预期3年生存率和无进展生存期分别为79%和75%。主要不良反应为骨髓抑制、胃肠道反应和血糖波动等,大多为轻中度,且化疗停止后很快缓解。无治疗相关死亡。结论:GDL方案治疗结外鼻型NK/T细胞淋巴瘤的疗效佳,毒副作用下且能耐受,联合累及野放疗治疗能够取得较为满意的疗效,值得进一步临床推广使用。OBJECTIVE： To evaluate the l：herapeutic effect and toxicities of gemcitabine combined with dexametha- sone and l-asparaginase （GDL regimen） on early stage extranodal nasal type NK/T-cell lymphoma. METHODS： A total of 48 newly diagnosed patients with extranodal NK/T-cell lymphoma treated with Gemcitabine, 1 000 mg/m2 , adding NS 100 mL, ivdrip, d1, d8; dexamethasone, 10 rng/m2, adding NS 250 mL, ivdrip, d1- d8; and 1-asparaginase, 5 000 U/m2 ,adding 5%GS 250 mL,ivdrip,dl--dT; Twenty-one days as one cycle. All patients received 4 cycles of the chemotherapy. The regimen was administered for 4 cycles and the response rate was evaluated. After three weeks addi- tional involved-filed irradiation was administered. RESULTS： There were 26 cases of CR （54. 2%）, 17 cases of PR （35.4%） ,4 cases of SD （8.3%） and only1 case ofPD （2.1%）. After radiotherapy there were 44 cases of CR （91.7%）, 4 cases of PR （8.3G） and the efficiency was 100%. After a median follow-up of 36（10--58） months the estimated 3-year overall survival （OS） rate was 79% and progression free survival （PFS） rate was 75%. Major adverse effect was myelo- suppression,gastrointestinal reactions and blood glucose fluctuation. No treatment-related deaths occurred. CONCLU- SIONS： Combined treatment with Gemcitabine, dexamethasone and l-asparaginase is effective and well tolerant for extran- odal nasal type NK/T-cell lymphoma. Joint involving-field radiotherapy can make a more satisfactory curative effect. It is worthy of further clinical use.

关 键 词：天冬酰胺酶 淋巴瘤 T细胞 放射疗法 药物疗法 

分 类 号：R733.1[医药卫生—肿瘤]