单独CAG方案及其联合地西他滨治疗急性髓系白血病的疗效及安全性比较  

Comparison of efficacy and safety of CAG alone and its combination with decitabine in the treatment of acute myeloid leukemia

作　　者：沈健[1] 郑瑞[1] SHEN Jian;ZHENG Rui(Department of Hematology Oncology, Taizhou Hospital in Zhejiang Province, Taizhou 317000, China)

机构地区：[1]浙江省台州医院血液肿瘤科

出　　处：《中国现代医生》2019年第18期80-83,共4页China Modern Doctor

基　　金：浙江省医药卫生科技计划项目(2014KYB311)

摘　　要：目的探讨单独CAG方案及其联合地西他滨(Decitabine,DAC)治疗急性髓系白血病(Acute myelocytic leukemia,AML)的效果及安全性差异,为临床优化治疗方案提供参考。方法选择本院2013年6月~2016年12月收治的50例AML患者为研究对象,采用单盲随机分组法分为两组:对照组和研究组各25例。对照组采用CAG化疗方案[阿克林霉素(ACR)+阿糖胞苷(Ara-C)+粒细胞集落刺激因子(G-CSF)]治疗,研究组采用CAG方案联合DAC治疗,均化疗2个疗程。观察两组临床缓解效果、毒副反应、生活质量以及随访1年、2年生存率情况。结果两组AML患者均成功完成治疗,研究组、对照组CR+PR分别占88.00%、60.00%,组间总缓解率比较差异有统计学意义(P<0.05)。两组AML患者各项毒副反应发生率比较,差异均无统计学意义(P>0.05)。研究组EORTC QLQ-C30量表中PF、EF、QL评分均高于对照组,差异有统计学意义(P<0.05)。两组均成功随访2年,无失访病例。研究组AML患者2年生存率76.00%高于对照组48.00%,差异有统计学意义(P<0.05)。结论 CAG方案联合DAC治疗AML可增益临床效果和提高生存率,且不增加毒副反应,临床应用价值显著。Objective To explore the efficacy and safety of CAG alone and its combination with decitabine(DAC) in the treatment of acute myelocytic leukemia(AML), and to provide a reference for clinical optimization of treatment options.Methods A total of 50 AML patients admitted to our hospital from June 2013 to December 2016 were enrolled in the study. They were divided into two groups by single-blind randomization: 25 cases in the control group and 25 in the study group. The control group was treated with CAG chemotherapy [Acrulin(ACR)+cytarabine(Ara-C)+granulocyte colony-stimulating factor(G-CSF)]. The study group was treated with CAG and DAC. Both groups were given 2 courses of chemotherapy. The clinical remission, toxicity, quality of life, and 1-year and 2-years survival rates of the two groups were observed. Results The AML patients in both groups were successfully treated. The CR+PR of the study group and the control group accounted for 88.00% and 60.00%, respectively. The difference of the total response rate between the two groups was statistically significant(P<0.05). There was no significant difference in the incidence of toxic and side effects between the two groups of AML patients(P>0.05). The scores of PF, EF and QL in the EORTC QLQ-C30 scale of the study group were higher than those in the control group, and the difference was statistically significant(P<0.05).Both groups were successfully followed up for 2 years without any loss of follow-up. The 2-year survival rate of the AML patients in the study group was 76.00%, higher than that in the control group(48.00%), and the difference was statistically significant(P<0.05). Conclusion The CAG regimen combined with DAC in the treatment of AML can improve the clinical effect and improve the survival rate, without increasing the toxicity and side effects, and the clinical application value is significant.

关 键 词：急性髓系白血病 CAG方案 地西他滨 缓解效果 毒副反应 生存率 

分 类 号：R733.71[医药卫生—肿瘤]