培门冬酶或门冬酰胺酶为主的化疗方案治疗结外自然杀伤/T细胞淋巴瘤患者的效果及耐受性  

Efficacy and tolerability of pegaspargase or asparaginase-based chemotherapy regimens in patients with extranodal natural killer/T-cell lymphoma

作　　者：李言冰 蔡玲玉 左宏波 LI Yanbing;CAI Lingyu;ZUO Hongbo(The Second Department of Oncology,Jiujiang No.1 People's Hospital,Jiujiang,Jiangxi,332000,China)

机构地区：[1]九江市第一人民医院肿瘤二科,江西九江332000

出　　处：《当代医学》2024年第25期56-60,共5页Contemporary Medicine

摘　　要：目的探讨培门冬酶或门冬酰胺酶为主的化疗方案治疗结外自然杀伤/T细胞淋巴瘤(extranodal natural killer/T-cell lymphoma,ENKTCL)患者的效果及耐受性。方法选取2021年1月至2022年1月九江市第一人民医院收治的80例初诊ENKTCL患者作为研究对象,随机分为观察组与对照组,每组40例。对照组给予门冬酰胺酶+DICE方案(异环磷酰胺+顺铂+依托泊苷+地塞米松),观察组给予培门冬酶+DICE方案。比较两组临床疗效、白细胞介素-2受体(soluble interleukin-2Receptor,sIL-2R)、凝血功能[凝血活酶时间(activated partial thromboplastin time,APTT)、凝血酶原时间(prothrombin time,PT)、纤维蛋白原(fibrinogen,FIB)]、不良反应发生情况、生命质量[功能评价系统-共性模块量表(functional assessment of cancer therapy generic scale,FACT-G)]及复发率。结果观察组客观缓解率为80.00%,高于对照组的55.00%,差异有统计学意义(P<0.05)。治疗1、4个疗程后,两组sIL-2R水平均低于前一个时间点,且观察组低于对照组,差异有统计学意义(P<0.05)。治疗后,两组APTT、PT均长于治疗前,FIB水平均低于治疗前,且观察组APTT、PT均长于对照组,FIB水平低于对照组,差异有统计学意义(P<0.05)。观察组骨髓抑制情况及过敏反应发生率均低于对照组,差异有统计学意义(P<0.05)。治疗后,两组FACT-G评分均高于治疗前,且观察组高于对照组,差异有统计学意义(P<0.05)。随访6个月,观察组复发率为17.50%,低于对照组的37.50%,差异有统计学意义(P<0.05)。结论相较于门冬酰胺酶,以培门冬酶为主的化疗方案治疗ENKTCL患者疗效显著,肿瘤细胞活跃程度较轻,不易影响患者凝血功能,提高其生命质量,ENKTCL复发率下降,不增加不良反应的发生,安全性较高。Objective To investigate the efficacy and tolerability of pegaspargase or asparaginase-based chemotherapy regimens in patients with extranodal natural killer/T-cell lymphoma(ENKTCL).Methods 80 newly diagnosed ENKTCL patients admitted to Jiujiang No.1 People's Hospital from January 2021 to January 2022 were selected as the study subjects,they were randomly divided into the observation group and the control group,with 40 cases in each group.The control group was given asparaginase+DICE regimen(ifosfamide+cisplatin+etoposide+dexamethasone),and the observation group was given pegaspargase+DICE regimen.The clinical efficacy,soluble interleukin-2 receptor(sIL-2R),coagulation function(activated partial thromboplastin time[APTT],prothrombin time[PT],fibrinogen[FIB]),adverse reactions,quality of life(functional assessment of cancer therapy generic scale[FACT-G])and recurrence rate were compared between the two groups.Results The objective remission rate in the observation group was 80.00%,which was higher than 55.00%in the control group,and the difference was statistically significant(P<0.05).After 1 and 4 courses of treatment,the levels of sIL-2R of the two groups were lower than those at the previous time point,and the observation group was lower than the control group,the differences were statistically significant(P<0.05).After treatment,APTT and PT of the two groups were lon-ger than those before treatment,FIB level was lower than that before treatment,APTT and PT in the observation group were longer than those in the control group,FIB level was lower than that in the control group,and the differences were statistically significant(P<0.05).The incidence of bone marrow suppression and allergic reactions in the observation group were lower than those in the control group,and the differences were statis-tically significant(P<0.05).After treatment,the FACT-G scores of the two groups were higher than those before treatment,and the observation group was higher than the control group,the differences were statistically signif

关 键 词：培门冬酶 左旋门冬酰胺酶 结外自然杀伤/T细胞淋巴瘤 化疗耐受性 

分 类 号：R733.1[医药卫生—肿瘤]