含聚乙二醇脂质体多柔比星的R-CDOP方案治疗弥漫性大B细胞淋巴瘤的临床应用评价  

Clinical evaluation of R-CDOP regimen containing pegylated liposomal doxorubicin in treatment of diff use large B-cell lymphoma

作　　者：常莹莹 朱斌 Chang Yingying;Zhu Bin(Department of Pharmacy,Fudan University Shanghai Cancer Center,Shanghai 200032,China;Department of Oncology,Shanghai Medical College,Fudan University,Shanghai 200032,China)

机构地区：[1]复旦大学附属肿瘤医院药剂科,上海200032 [2]复旦大学上海医学院肿瘤学系,上海200032

出　　处：《实用肿瘤杂志》2021年第5期429-434,共6页Journal of Practical Oncology

摘　　要：目的评价将R-CHOP方案(利妥昔单抗+环磷酰胺+长春新碱+多柔比星+泼尼松)中的多柔比星改为含聚乙二醇脂质体多柔比星的R-CDOP方案治疗弥漫性大B细胞淋巴瘤患者的疗效和安全性。方法回顾性收集76例弥漫性大B细胞淋巴瘤患者的临床资料,其中39例使用标准的R-CHOP方案化疗(R-CHOP组),37例使用含多柔比星脂质体的R-CDOP方案化疗(R-CDOP组)。分析两组患者的治疗完全缓解率、客观缓解率、疾病控制率、一般不良反应以及心脏毒性。结果R-CHOP组和R-CDOP组患者的完全缓解率分别为74.3%和73.0%,客观缓解率为94.9%和94.6%,疾病控制率为94.9%和97.3%,差异均无统计学意义(均P>0.05)。两组患者均出现血小板减少、中性粒细胞减少伴发热、肝功能异常、尿酸升高、口腔黏膜炎和外周神经毒性,差异均无统计学意义(均P>0.05)。R-CDOP组患者白细胞减少和中性粒细胞减少的发生率均低于R-CHOP组(78.3%vs 97.4%,75.7%vs 89.7%,均P<0.05)。两组患者心电图异常的发生率比较,差异具有统计学意义(P<0.01)。结论含脂质体多柔比星的R-CDOP方案能够减轻弥漫性大B细胞淋巴瘤患者的血液学不良反应和心脏毒性,安全性高,疗效与传统的R-CHOP方案一致。Objective To evaluate the efficacy and safety of R-CDOP regimen,a modified version of R-CHOP regimen(rituximab+cy-clophosphamide+doxorubicin+vincristine+prednisone)with doxorubicin replaced by pegylated liposomal doxorubicin(PLD)in the treat-ment of diffuse large B-cell lymphoma(DLBCL).Methods The clinical data of 76 patients with DLBCL were collected retrospectively,including 39 cases treated with standard R-CHOP regimen(R-CHOP group)and 37 cases treated with R-CDOP regimen(R-CDOP group).The complete response rate,objective response rate(ORR),disease control rate,general adverse events and cardiotoxicity were compared between the two groups.Results The complete response rate,objective response rate and disease control rate were 74.3%vs 73.0%,94.9%vs 94.6%,and 94.9%vs 97.3%in the R-CHOP group and the R-CDOP group,with no statistical significance(all P>0.05).There were no significant differences in thrombocytopenia,neutropenia with fever,abnormal liver function,elevated uric acid,mucositis,and peripheral neurotoxicity between the two groups(all P>0.05).The incidence of leukopenia and neutropenia in the R-CDOP group was significantly lower compared with that in the R-CHOP group(78.3%vs 97.4%;75.7%vs 89.7%,both P<0.05);The difference in the inci-dence of ECG abnormalities was statistically significant between the two groups(P<0.01).Conclusions The R-CDOP regimen containing PLD can reduce cardiotoxicity and hematological adverse events in patients with DLBCL,showing high safety and consistent efficacy with the traditional R-CHOP regimen.

关 键 词：弥漫性大B细胞淋巴瘤 多柔比星脂质体 疗效 不良反应 

分 类 号：R733.1[医药卫生—肿瘤]