Hyper-CVAD/MA和CHOP方案治疗外周T细胞淋巴瘤非特指型的78例临床分析  

Clinical analysis of Hyper-CVAD/MA regimen and CHOP/CHOP-like regimen in the treatment of 78 patients with peripheral T-cell lymphoma, not otherwise specified(PTCL-NOS)

作　　者：林凌[1,2,3] 宋腾[2] 张亚瑞[2] 常智[2] 宋拯[1] 周世勇[1] 钱正子[1] 张会来[1] 王华庆[1,2] 

机构地区：[1]天津医科大学肿瘤医院淋巴瘤科,国家肿瘤临床医学研究中心,天津市肿瘤防治重点实验室,天津市300060 [2]天津市人民医院肿瘤诊治中心 [3]天津医科大学宝坻临床学院肿瘤科

出　　处：《中国肿瘤临床》2016年第11期486-492,共7页Chinese Journal of Clinical Oncology

摘　　要：目的:比较Hyper-CVAD/MA与CHOP方案一线治疗外周T细胞淋巴瘤-非特指型(peripheral T-cell lymphoma,not otherwise specified,PTCL-NOS)的临床疗效和不良反应。方法:回顾性分析天津医科大学肿瘤医院和天津市人民医院肿瘤中心2004年6月至2012年6月收治的78例初诊PTCL-NOS患者,根据一线治疗分成Hyper-CVAD/MA方案组(21例)和CHOP/CHOP样方案组(57例),采用χ2检验分析近期疗效及不良反应,应用Kaplan-Meier法进行生存分析。结果:Hyper-CVAD/MA组中完全缓解(complete response,CR)为42.9%,总有效率(overall response rate,ORR)为85.7%,中位无进展生存期(progression-free survival,PFS)为20个月,3年总生存期(overall survival,OS)为56.9%;CHOP/CHOP样组中CR为28.1%,ORR为59.6%,中位PFS为13个月,3年OS为49.6%。Hyper-CVAD/MA组总有效率和中位PFS显著高于后者(P<0.05)。而两组患者复发率(57.1%vs.77.2%)和3年OS差异无统计学意义(P>0.05)。不良反应方面,两组Ⅲ/Ⅳ级粒细胞减少发生率分别为66.7%和22.8%,Ⅲ/Ⅳ级血小板减少发生率分别为61.9%和14.0%,Hyper-CVAD/MA组骨髓抑制显著高于后者(P<0.05)。结论:Hyper-CVAD/MA方案治疗PTCL-NOS疗效较好,不良反应较高但可控,建议在粒细胞集落刺激因子支持下进行。Objective：To compare the therapeutic efficacy and safety of Hyper-CVAD/MA regimen and CHOP/CHOP-like regimen in the treatment of peripheral T-cell lymphoma, not otherwise specified （PTCL-NOS）. Methods：The 78 primary PTCL-NOS patients who were initially diagnosed and treated in Tianjin Medical University Cancer Institute and Hospital and Tianjin Union Medical Center from June 2004 to June 2012 were retrospectively analyzed. The patients were then divided into two groups：Hyper-CVAD/MA group （n=21） and CHOP/CHOP-like group （n=57）. Curative efficacies and toxicities were analyzed by Chi-square test, and survival was estimated by Ka-plan-Meier method. Results： In the Hyper-CVAD/MA group, complete response （CR） was 42.9%, overall response rate （ORR） was 85.7%, median progression-free survival （PFS） was 20 months, and the three-year overall survival （OS） was 56.9%. In the CHOP/CHOP-like group, the CR, ORR, and three-year OS were 28.1%, 59.6%, and 49.6%, respectively, and the median PFS was 13 months. Compara-tive analysis showed that the ORR and three-year OS were statistically significant （P〈0.05）, but the relapse rates （57.1%versus 77.2%） and three-year OS were similar （P〉0.05）. The incidence rates ofⅢ/Ⅳneutrocytopenia and thrombocytopenia in Hyper-CVAD/MA group （66.7%and 61.9%, respectively） were significantly higher than those of the CHOP/CHOP-like group （22.8%and 14.0%, respec-tively） （P〈0.05）. Conclusion：Hyper-CVAD/MA regimen can achieve satisfactory efficacy in parents with PTCL-NOS, and toxicity can be controlled with granulocyte colony stimulating factor （G-CSF）.

关 键 词：外周T细胞淋巴瘤-非特指型 Hyper-CVAD/MA方案 疗效 安全性 

分 类 号：R733.1[医药卫生—肿瘤]