结外NK/T细胞淋巴瘤L-GEMOX方案治疗的临床观察  

Clinical observation of extranodal NK/T- cell lymphoma patients treated by L- GEMOX regimen

作　　者：汪春秀[1] 张智慧[1] 

机构地区：[1]四川省肿瘤医院肿瘤内科,四川成都610041

出　　处：《现代肿瘤医学》2014年第6期1434-1437,共4页Journal of Modern Oncology

摘　　要：目的:观察L-GEMOX方案对结外NK/T细胞淋巴瘤的近期疗效和安全性。方法:回顾性分析32例经病理形态学及免疫组化证实为结外NK/T细胞淋巴瘤患者,均接受L-GEMOX方案治疗,至少接受2个周期。32例患者接受4个周期化疗后行疗效评价,诱导化疗后行序贯累计野放疗。结果:32例结外NK/T细胞淋巴瘤患者中,诱导化疗后完全缓解(CR)率为53.1%(17/32),部分缓解(PR)率为31.3%(10/32),疾病稳定(SD)率为9.4%(3/32),疾病进展(PD)率为6.3%(2/32)。完成放射治疗后,CR率为62.5%(20/32),PR率37.5%(12/32),有效率为100%。临床特征分析显示原发部位、临床分期与患者近期疗效相关(P<0.05)。主要不良反应为骨髓抑制、黏膜炎、转氨酶升高及血糖波动等,多为轻中度,予对症处理或化疗停止后很快缓解。无治疗相关死亡。结论:培门冬酶及吉西他滨联合奥沙利铂(L-GEMOX)作为一线诱导化疗方案,对结外NK/T细胞淋巴瘤的近期疗效佳,不良反应轻,安全性好,是Ⅰ期、Ⅱ期鼻NK/T细胞淋巴瘤新的治疗选择。将来需进一步开展大样本的前瞻性研究,评估L-GEMOX方案能否改善结外NK/T细胞淋巴瘤的总生存期和无病生存期。Objective：To observe the therapeutic efficacy and security of the L-GEMOX regimen in extranodal NK/T-cell lymphoma. Methods：Thirty-two patients with diagnoses of morphological and immunohistochemical ex-tralnodal NK/T-cell lymphoma were treated by L-GEMOX regimen,twenty-one days as one cycle. All patients re-ceived at least 2 cycles chemotherapy. The regimen was administered for 4 cycles and the response rate was evaluated. After induced chemotherapy addtionnal involved-fieled sequential irradiation was administered. Results：There were 17 cases of CR（53. 1%）,10 cases PR（31. 3%）,3 cases SD（9. 4%）,2 case PD（6. 3%）. After radiotherapy there were 20 cases of CR（62. 5%）,12 cases PR（37. 5%）and efficiency was 100%. Primary site and clinicla stage were associated with short-term efficacy（P〈0. 05）. Major adverse reactions were myelo-suppression,mucosctis,elevat-ed aminotransferases and blood glucose fluctuations,no treatment-related deaths occurred. Conclusion：Combined treatment of gemcitabine,oxaliplatin and Pei enzymes as first-line induction chemotherapy is effective and well toler-ant for eatralnodal NK/T-cell lymphoma. It may be a new treatment option forⅠ,Ⅱof nasal NK/T-cell and need to be carried out By large prospective study to assess the possibility of improving overall survival and disease-free survive of extralnodal NK/T-cell lymphoma.

关 键 词：结外NK T细胞淋巴瘤 L-GEMOX方案 安全性 疗效 

分 类 号：R733.4[医药卫生—肿瘤]