不同硼替佐米剂量的PAD化疗方案治疗多发性骨髓瘤后患者的临床疗效和不良反应的评估  

Assessment of clinical efficacy and adverse reactions of different dose of Bortezomib in PAD chemotherapy treatment for patients with multiple myeloma

作　　者：李学亮[1] 袁明智[1] 

机构地区：[1]临沂市人民医院,山东临沂276003

出　　处：《中国现代医学杂志》2014年第30期84-87,共4页China Journal of Modern Medicine

摘　　要：目的观察标准剂量和低剂量两种PAD方案治疗多发性骨髓瘤(MM)患者的疗效和不良反应。方法快速静脉给予1.3 mg/m2或1.6 mg/m2两种不同剂量的硼替佐米,同期应用地塞米松和多柔比星。疗效判定采用2006年国际骨髓瘤工作组制定的标准,不良反应分级参照美国国立癌症研究院不良事件通用名。结果第2个疗程结束后,标准剂量组的有效率为41.38%,低剂量组的有效率为83.33%,低剂量组有效率明显高于标准剂量组(P<0.05)。完全缓解(CR)多在完成第3或4疗程后获得,标准剂量组共11例达到CR,占34.38%。低剂量组有5例达到CR,占35.71%,两组比较差异无显著性(c2=0.008,P>0.05);32例标准剂量组的患者共出现20例胃肠道不良反应,占62.50%。14例低剂量组患者出现8例,占57.14%。两组进行比较差异无统计意义(c2=0.117,P>0.05)。标准剂量组的患者有18例出现周围神经病变,占56.25%。低剂量组有8例,占57.14%,两组比较差异无显著性(c2=0.003,P>0.05)。对两组患者出现血液系统毒性进行比较,差异均无显著性(P>0.05)。结论 PAD方案治疗MM效果显著,增加每次硼替佐米的量,减少总剂量,起效快,不影响总有效率,同时也不增加患者的不良反应。【Objective】To observe the efficacy and adverse reactions of two PAD regimen with standard-dose and low-dose on multiple myeloma（MM） patients.【Methods】Rapid intravenous of 1.3 mg/m2 or 1.6 mg/m2 two different doses of Bortezomib, dexamethasone and doxorubicin were used at the same period. The efficacy was determined by the standard of International Myeloma Working Group in 2006, graded of adverse reactions by the generic name events of U.S. National Cancer Institute. 【Results】After the first two courses, the effective rate of standard-dose group was 41.38%, the effective rate of the low dose group was 83.33%, the effective rate of low dose group was significantly higher than the standard-dose group（P〉0.05）. CR was available after completing more than 3 or 4courses, 11 patients achieved CR in the standard-dose group, accounting for 34.38%. 5 patients achieved CR in the low-dose group, accounting for 35.71%, the difference was not statistically significant（c2=0.008, P〉0.05）; a total of20 cases in the standard-dose group（32 patients） appeared of gastrointestinal adverse reactions, accounting for62.50%, low-dose group were 8 cases, accounting for 57.14%. Difference between the two groups was not statistically significant（c2=0.117, P〉0.05）. Patients with standard-dose group, 18 patients had peripheral neuropathy, accounting for 56.25%. Low-dose group had eight cases, accounting for 57.14%, the difference was not statistically significant（c2=0.003, P〉0.05）. The difference of patients in the two groups with hematological toxicity was no sta-tistically significant（P〉0.05）. 【Conclusions】PAD regimen therapy MM has prominence effect, increasing the amount of Bortezomib each time, reducing the total dose, rapid onset, does not affect the total efficiency, while not increase adverse reactions.

关 键 词：多发性骨髓瘤 硼替佐米 地塞米松 多柔比星 

分 类 号：R733.3[医药卫生—肿瘤]