硼替佐米联合环磷酰胺及地塞米松治疗多发性骨髓瘤的疗效观察  

Observation on efficacy of bortezomib combined with cyclophosphamide and dexamethasone in the treatment of multiple myeloma

作　　者：张秀娟 ZHANG Xiu-juan(Departmebt of Hematology,Juye County People's Hospital,Heze 274900,China)

机构地区：[1]山东省巨野县人民医院血液内科,274900

出　　处：《中国实用医药》2023年第3期115-117,共3页China Practical Medicine

摘　　要：目的观察硼替佐米联合环磷酰胺及地塞米松在多发性骨髓瘤治疗中的疗效及安全性。方法67例多发性骨髓瘤患者,随机分为观察组(33例)和对照组(34例)。观察组采用硼替佐米联合环磷酰胺及地塞米松方案治疗,对照组采用传统的长春新碱+阿霉素+地塞米松(VAD)方案治疗。比较两组患者治疗2、4个疗程后的临床疗效,毒副作用发生情况。结果治疗2个疗程后,观察组的完全缓解(CR)率33.3%高于对照组的11.8%,差异具有统计学意义(P<0.05);两组患者的总有效率比较,差异无统计学意义(P>0.05)。治疗4个疗程后,观察组的CR率63.6%、总有效率90.9%均高于对照组的32.4%、67.6%,差异具有统计学意义(P<0.05)。观察组患者的胃肠反应、中性粒细胞减少、血小板减少发生率分别为45.5%、30.3%、24.2%,均低于对照组的76.5%、55.9%、52.9%,差异具有统计学意义(P<0.05);两组患者的周围神经病变发生率比较,差异无统计学意义(P>0.05)。结论硼替佐米联合环磷酰胺及地塞米松较传统VAD方案治疗多发性骨髓瘤的CR率更高,具有更好的疗效,且安全性更高。Objective To observe the efficacy and safety of bortezomib combined with cyclophosphamide and dexamethasone in the treatment of multiple myeloma.Methods A total of 67 patients with multiple myeloma were randomly divided into an observation group(33 patients)and a control group(34 patients).The observation group was treated by bortezomib combined with cyclophosphamide and dexamethasone regimen,while the control group was treated with the conventional vincristine+adriamycin+dexamethasone(VAD)regimen.The clinical efficacy after 2 and 4 courses of treatment,and the occurrence of toxic side effects were compared between the two groups.Results After 2 courses of treatment,the complete remission(CR)rate in the observation group was 33.3%,and the difference was statistically significant compared with 11.8%in the control group(P<0.05).The difference was not statistically significant when comparing the total effective rate of the two groups(P>0.05).After 4 courses of treatment,the CR rate 63.6%and total effective rate 90.9%in the observation group were higher than 32.4%and 67.6%in the control group,and the difference was statistically significant(P<0.05).The incidence of gastrointestinal reaction,neutropenia,and thrombocytopenia in the observation group were 45.5%,30.3%,and 24.2%,which were lower than 76.5%,55.9%,and 52.9%in the control group,and the differences were statistically significant(P<0.05).The differences were not statistically significant when comparing the incidence of peripheral neuropathy in the two groups(P>0.05).Conclusion Bortezomib combined with cyclophosphamide and dexamethasone in the treatment of multiple myeloma has higher CR rate,better efficacy,and higher safety than the conventional VAD regimen.

关 键 词：硼替佐米 环磷酰胺 地塞米松 多发性骨髓瘤 

分 类 号：R733.3[医药卫生—肿瘤]