(R)-EPOCH方案治疗39例初发弥漫大B细胞淋巴瘤的长期随访研究  

Long-term Follow-Up for 39 Newly Diagnosed Diffused Large Bcell Lymphoma Patients Treated by(R)-EPOCH

作　　者：杨小燕[1] 翟勇平[1] 刘海宁[1] 于亚平[1] 李锋[1] 宋萍[1] 周小钢[1] 安志明[1] 王利平[1] 

机构地区：[1]南方医科大学南京临床学院(南京军区南京总医院)血液科,江苏南京210002

出　　处：《中国实验血液学杂志》2014年第2期333-338,共6页Journal of Experimental Hematology

摘　　要：本研究旨在观察(R)-EPOCH方案治疗初发弥漫大B细胞淋巴瘤的近远期疗效及安全性。2004年2月至2009年4月39例采用(R)-EPOCH方案治疗的初发弥漫大B细胞淋巴瘤患者纳入本研究。患者中位年龄52岁(16-85岁),Ann-Arbor分期为Ⅰ期/Ⅱ期24例,为Ⅲ期/Ⅳ期15例,其中Ann-Arbor分期为Ⅰ/Ⅱ期的患者接受4-6个疗程(R)-EPOCH方案,Ⅲ/Ⅳ期患者接受6-8个疗程(R)-EPOCH方案治疗,对于伴巨大肿块的患者化疗后再行局部放射治疗。结果表明,39例患者共接受209个疗程化疗,中位疗程数为6个(2-8个)。全部均可以评价疗效,39例患者中28例(71.8%)完全缓解,6例(15.4%)部分缓解,总有效率达87.2%。中位随访时间57.7个月,1年、3年、5年的总生存率分别为81.8%、70.9%、58.8%。化疗期间的主要不良反应为血液学毒副反应,其中Ⅲ-Ⅳ度粒细胞减少发生率为29.2%,Ⅲ-Ⅳ度贫血的发生率为14.4%,其他不良反应轻微或少见,无化疗相关死亡。截止最终随访时间,无继发性肿瘤的发生。结论:(R)-EPOCH方案对初发弥漫大B细胞淋巴瘤有较好的疗效,且安全性好。The purpose of this study was to evaluate the efficacy and safety of （R）-EPOCH protocol on patients with diffuse large B-cell lymphoma（DLBCL）. From February 2004 to April 2009, a total of 39 patients who suffered from DLBCL and received （R） -EPOCH protocol were enrolled in the study. The median age of patients was 52 years old. 24 patients were on stage Ⅰ / Ⅱ , and 15 cases were on stage Ⅲ/Ⅳ. Patients with stage Ⅰ/ Ⅱ were administered with 4 - 6 cycles of （R）-EPOCH, while other patients with stage Ⅲ/Ⅳ received 6 -8 cycles of （R）-EPOCH. DLBCL patients with bulky disease received radiotherapy after completion of chemotherapy. 39 patients received a total of 209 cycles of chemotherapy and the median chemotherapy cycles was 6 （range, 2 -8 cycles）. The results showed that the overall re- sponse rate of 39 assessable patients was 87.2%, including 28 patients（71.8% ） in complete remission（CR） and 6 pa- tients （15. 4% ） in partial remission（PR）. With a median follow-up of 57.7 months, the 1-year overall survival rate was 81.8%, while 70.9% for 3-year and 58.8% for 5-year. The major toxicity of （R） -EPOCH potocol was hemato- logic toxicity and the incidence of grade Ⅲ- Ⅳ neutropenia and anemia were 29.2% and 14.4%, respectively. Other toxicities were mild, no treatment-related deaths occurred. At the end of follow-up, no secondary tumors occurred. It is concluded that （R）-EPOCH protocol is a effective and safe protocol for the patients with DLBCL.

关 键 词：淋巴瘤 弥漫大B细胞淋巴瘤 (R)-EPOCH方案 

分 类 号：R733.1[医药卫生—肿瘤]