吉西他滨对比长春瑞滨化疗方案治疗复发性非霍奇金淋巴瘤的临床疗效和不良反应观察  

Effects and adverse events of gemcitabine compared with vinorelbine based regimen in the treatment of relapsed non-Hodgkin’s lymphoma

作　　者：花京剩 罗爽[1] 仇惠英[2] HUA Jingsheng;LUO Shuang;QIU Huiying(Department of Hematology,Taizhou Municipal Hospital of Zhejiang Province,Taizhou,318000,China;Jiangsu Instituteof Hematology,the First Affiliated Hospital of Soochow University)

机构地区：[1]浙江省台州市立医院血液科,浙江台州318000 [2]苏州大学附属第一医院血液病研究所

出　　处：《临床血液学杂志》2020年第4期493-497,共5页Journal of Clinical Hematology

基　　金：江苏省自然科学基金(No:BE2018652)。

摘　　要：目的:探究不同化疗方案治疗复发性非霍奇金淋巴瘤(NHL)的效果和不良反应。方法:选取2016-01-2018-01来我院就诊的90例复发性NHL患者,随机分为吉西他滨组和长春瑞滨组,每组各45例。吉西他滨组采用吉西他滨和奥沙利铂治疗,长春瑞滨组采用长春瑞滨和奥沙利铂治疗。治疗6个周期后比较2组患者的临床疗效、不良反应发生情况、总生存率、无进展生存率,比较治疗前后2组患者KPS评分。结果:治疗6个周期后,吉西他滨组总有效率为60.00%,明显高于长春瑞滨组的37.78%(P<0.05);长春瑞滨组KPS评分显著低于吉西他滨组(P<0.05)。2组均出现明显不良反应,主要为白细胞下降和血小板减少(P>0.05)。吉西他滨组和长春瑞滨组的总生存率分别为66.67%和62.22%(P>0.05);吉西他滨组无进展中位生存时间为15.5个月,长春瑞滨组为13.5个月(P>0.05)。所有复发淋巴瘤患者多因素分析提示,年龄、Ann Arbor分期、预后指数、病理类型独立地影响患者长期生存(P<0.05)。结论:采用吉西他滨和奥沙利铂治疗复发性NHL具有更高的有效率,不良反应可接受,具有一定的临床应用价值。Objective:To explore the effect and adverse events of different chemotherapy regimens in the treatment of relapsed non-Hodgkin’s lymphoma(NHL).Method:A total of 90 patients with relapsed NHL who were admitted to the hospital between January 2016 and January 2018 were randomly divided into the gemcitabine group and the vinorelbine group with 45 cases in each group.The gemcitabine group was treated with gemcitabine and oxaliplatin while the vinorelbine group was treated with vinorelbine and oxaliplatin.After 6 cycles of treatment,the clinical efficacy,incidence of adverse events,overall survival rate and progression-free survival rate were compared between the two groups.The KPS scores of the two groups were compared before and after treatment.Result:After 6 cycles of treatment,the total response rate of the gemcitabine group was higher than that of the vinorelbine group(60.00% vs 37.78%)(P<0.05).The KPS score of the vinorelbine group was lower than that of the gemcitabine group(P<0.05).There were adverse events in both group which mainly included leukopenia and thrombocytopenia(P>0.05).The overall survival rate of the gemcitabine group and the vinorelbine group was 66.67% vs 62.22%(P>0.05).The median progression-free survival time of the gemcitabine group and the vinorelbine group was 15.5 months and 13.5 months,respectively(P>0.05).The multivariate analysis of all patients with relapsed lymphoma suggested that age,Ann Arbor stage,international prognosis index and pathological type had independent influence on long-term survival of patients(P<0.05).Conclusion:The treatment with gemcitabine and oxaliplatin is more effective for relapsed NHL,with a certain clinical application value.

关 键 词：非霍奇金淋巴瘤 复发 吉西他滨 长春瑞滨 奥沙利铂 

分 类 号：R733.4[医药卫生—肿瘤]