硼替佐米皮下注射治疗多发性骨髓瘤的疗效及安全性观察  

The Efficacy and Side Effects of Subcutaneous Injection of Bortezomib in the Treatment of Multiple Myeloma

作　　者：孙玉娇[1] 许宏[1] 郭振清[1] 鞠小妍[1] 崔中光[1] 赵洪国[1] SUN Yujiao;XU Hong;GUO Zhenqing;JU Xiaoyan;CUI Zhongguang;ZHAO Hongguo(Department of Hematology,the Affiliated Hospital of Qingdao University,Qingdao,Shandong,266000,China)

机构地区：[1]青岛大学附属医院

出　　处：《肿瘤药学》2019年第5期783-788,共6页Anti-Tumor Pharmacy

摘　　要：目的探讨硼替佐米皮下注射治疗多发性骨髓瘤的疗效及副作用。方法回顾性分析我院2013年1月-2018年1月收治的166名采用硼替佐米治疗的多发性骨髓瘤患者,其中117例采用皮下注射(SC)、49例采用静脉注射(Ⅳ),比较两组患者疗效及不良反应的发生情况。结果治疗2个疗程及4个疗程后,两组患者的完全缓解率(CR)、非常好的部分缓解率(VGPR)、部分缓解率(PR)均无明显差异(P>0.05),但截至硼替佐米治疗终止(皮下组3~18个疗程,平均8.5个疗程;静脉组3~16个疗程,平均6.6个疗程),皮下组PR率显著高于静脉组(P<0.001),两组之间PFS及OS比较未见明显差异(P>0.05)。静脉组感染的发生率、所有级别周围神经病变(PN)发生率及3级以上PN发生率均显著高于皮下组(P<0.05),其余副作用两组相比未见明显差异(P>0.05)。结论硼替佐米皮下注射与静脉注射相比早期疗效相当,但可明显降低周围神经病变的发生,提高了用药安全性。Objective To explore the clinical effects of subcutaneous injection of bortezomib on multiple myeloma and its side effects.Methods Clinical data of 166 patients with multiple myeloma treated in our hospital between January 2013 and January 2018 were analyzed.Of the patients,117 cases got subcutaneous injection of bortezomib(SC group),and the other 49 cases got intravenous infusion of bortezomib(Ⅳgroup).The curative effects and the incidence of adverse reactions of patients in the two groups were observed and compared.Results After 2 courses of treatment,the percentages of complete remission(CR)cases,of very good partial remission(VGPR)cases and of partial response(PR)cases showed no statistical differences between two groups(P>0.05),and so did they after 4 courses of treatment(P>0.05).Patients in SC group completed 3~18 courses of treatment,8.5 courses in average,and those inⅣgroup completed 3~16 courses of treatment,6.6 courses in average.At the end of the treatment with bortezomib,the percentage of PR in SC group was higher than inⅣgroup(P<0.001).No significant difference in PFS and OS were found between two groups(P>0.05).The incidence of all grades of peripheral neuropathy(PN)and the incidence of PN above gradeⅢwere significantly lower in SC group than in Ⅳ group(P<0.05).The incidence of infection was lower in SC group than in IV group(P<0.05).No significant differences were found in other side effects between the two groups(P>0.05).Conclusion The SC injection of bortezomib had comparable early efficacy withⅣinjection.It could also reduce the occurrence of PN and improve the drug safety.

关 键 词：多发性骨髓瘤 硼替佐米 皮下注射 周围神经病变 

分 类 号：R733.3[医药卫生—肿瘤]