右丙亚胺联合CHOP方案治疗老年侵袭性非霍奇金淋巴瘤的疗效观察  

Clinical study on dexrazoxane combined with CHOP in the treatment of elderly patients with aggressive non-Ho-dgkin＇s lymphoma

作　　者：汪蕾[1,2] 朱琦 唐勇 邹丽芳 励菁菁 庄衍 林文洁 胡均培 叶为德 

机构地区：[1]同济大学医学院临床医学系,上海市200092 [2]上海第九人民医院血液科,上海市200011

出　　处：《老年医学与保健》2013年第1期28-30,共3页Geriatrics & Health Care

基　　金：上海市卫生局科研课题（2010101）

摘　　要：目的评价和比较右丙亚胺联合CHOP（D-CHOP）方案与单用CHOP方案治疗老年侵袭性非霍奇金淋巴瘤的临床疗效和不良反应。方法2010年1月至2012年6月共入组40例侵袭性非霍奇金淋巴瘤老年患者，随机分入D-CHOP方案组与CHOP方案组，每组各20例，比较两组的完全缓解率、总体缓解率以及不良反应情况。结果D-CHOP组和CHOP组的完全缓解率相似（55％vs50％，P=0．752），而两组总体缓解率差异亦无统计学意义（70％VS65％，P=0．736）。血液学毒性、胃肠道反应、肝。肾功能异常指标两组差异均没有统计学意义，但D-CHOP组患者心肌受损指标肌钙蛋白I和心脏超声的心肌活动指数（Tei指数）低于CHOP组（0．10vs0．13，P=0．021：0．45vs0．50．P〈0．01），差异有统计学意义。两组心电图异常发生率差异无统计学意义（25％vs30％，P=0．723）。结论D-CHOP方案是治疗老年侵袭性非霍奇金淋巴瘤患者的有效方案之一，其中右丙亚胺可在不影响疗效的前提下能有效减轻化疗相关的心脏毒性。Objective To compare the efficacy and toxicity of dexrazoxane combined with CHOP （D-CHOP） and CHOP regimen for elderly patients with aggressive non-Hodgkin＇s lymphoma. Method From Jan. 2010 to Jun. 2012, a total of 40 patients were enrolled. All the patients were randomized into two groups： 20 patients received CHOP alone （CHOP group） and 20 patients received dexrazoxane combined with CHOP regimen （D-CHOP group）. The complete re- sponse rates, overall response rates and adverse events of the two groups were compared. Results The complete response rates were similar in D-CHOP and CHOP groups （55% vs 50%, P=0.752）. The overall response rates were slightly higher in D-CHOP group than in CHOP group without statistical significance （70% vs 65 %, P =0.736）. There was no dif- ference in hematological toxicity, gastrointestinal reaction, liver and kidney disfuhction between two groups. It was also shown that troponin I, a biomarker reflecting myocardial damage, as well as Tei index, an echocardiogram myocardial performance indicator, was significantly lower in D-CHOP group than that in CHOP group （0.10 vs 0. 13, P=0.021 ; 0.45 vs 0.50, P 〈 0.01） although the occurrence of electrocardiographic abnormality was similar between two groups （25 % vs 30%, P=0.723）. Conclusion D-CHOP regimen was an effective therapeutic schedule for elderly patients with aggressive non-Hodgkin＇s lymphoma. Meanwhile, dexrazoxane effectively alleviated chemotherapy-associated cardiotoxicity without impairment of treatment efficacy.

关 键 词：非霍奇金淋巴瘤 右丙亚胺 化疗 老年患者 

分 类 号：R733.405.3[医药卫生—肿瘤]