VD方案和VAD方案治疗多发性骨髓瘤的疗效观察和比较  

Efficacy observation and comparison of VD regimen and VAD regimen for the treatment of multiple myeloma

作　　者：赵金平 潘政杰[2] 万军[3] 赖永榕[4] 彭志刚[4] 李桥川[4] 

机构地区：[1]高埗医院骨科,东莞523270 [2]第二军医大学研究生管理大队临床9队,上海200433 [3]广西玉林市第一人民医院血液科,玉林537000 [4]广西医科大学第一附属医院血液科,南宁530021

出　　处：《中国骨质疏松杂志》2013年第7期710-712,720,共4页Chinese Journal of Osteoporosis

摘　　要：目的探讨VD方案和VAD方案治疗多发性骨髓瘤的临床疗效和安全性。方法回顾性分析了2008年6月到2011年6月我院收治的59例多发性骨髓瘤患者的临床资料,根据治疗方案将患者分为VD组(38例)和VAD组(21例),VD组接受硼替佐米联合地塞米松治疗,3周为一个疗程,治疗2个疗程;VAD组接受长春新碱、阿霉素联合地塞米松治疗,4周为一疗程,治疗2个疗程。分别对两组疗效和不良反应进行分析。结果 VD组和VAD组治疗缓解率分别为83.78%和59.09%,VD方案优于VAD方案,差异具有统计学意义(P<0.05)。VD组主要不良反应为血液毒性和周围神经病变,症状较轻微,在停药和对症处理后症状消失或缓解。VAD组主要不良反应为感染、脱发和血液毒性等,其中感染多以3～4度为主。结论 VD方案治疗多发性骨髓瘤疗效优于VAD方案,不良反应轻微,患者可耐受,值得临床推广使用。Objective To investigate the efficacy and safety of VD regimen and VAD regimen for the treatments of multiple myeloma. Methods The clinical data of 59 patients with multiple myeloma, who came to our hospital from June 2008 to June 2011, were retrospectively analyzed. All the patients were divided into 2 groups according to different regimens： VD group （n = 38） and VAD group （n = 21 ）. Patients in the VD group were treated with bortezomib combined dexamethasone for 3 weeks as a treatment course and lasted for 2 courses. Patients in the VAD group were treated with vincristine, doxorubicin, and dexamethasone for 4 weeks as a treatment course and lasted for 2 courses. The efficacy and the side effects were analyzed in both groups. Results The relieve rate in VD group and VAD group was 83.78% and 59.09% , respectively. The efficacy in the VD group was significantly higher than that in the VAD group （P 〈 0.05 ）. The side effects in the VD group were mainly haematologic, gastrointestinal and peripheral neuropathic reactions. The adverse events were mild. After drug withdrawal or treatment, the symptoms disappeared or relieved. The main side effects in the VAD group were hematotoxicity, infection, and loss of hair. Most of the infectious patients in VAD group were grade III to IV. Conclusion The efficacy of VD regimen for the treatment of multiple myeloma is superior to that of VAD regimen. VD regimen has less and tolerable side effects, which deserves to be widely used in clinical work.

关 键 词：VD方案 VAD方案 多发性骨髓瘤 疗效 不良反应 

分 类 号：R733.3[医药卫生—肿瘤]