摘要
背景和目的外周T细胞淋巴瘤(peripheralT-celllymphoma,PTCL)与B细胞非霍奇金淋巴瘤(non-Hodgkinslymphoma,NHL)相比,往往表现为化疗敏感性差、容易复发、预后不良,目前尚无标准化疗方案。CHOP(CTX、ADM、VCR、prednisone)方案治疗PTCL疗效不理想,本试验旨在探索持续静脉灌注EPOCH(VP-16、EPI/ADM、VCR、CTX、prednisone)方案治疗PTCL的疗效和不良反应。方法在2001年11月～2004年4月期间,共收治PTCL21例,其中7例外周T细胞淋巴瘤-非特指型(PTCL-U),7例鼻型NK/T细胞淋巴瘤(NK/TCL),5例间变大细胞淋巴瘤(ALCL),1例蕈样肉芽肿/Sezary综合征(MF/SS),1例皮下脂膜炎样T细胞淋巴瘤(SPTCL);其中14例初治,7例复治。所有患者接受EPOCH化疗1～7个疗程(中位疗程数3个)。结果21例PTCL患者中20例可评价疗效,总的客观有效率(RR)85%(17/20),完全缓解率(CR率)50%(10/20)。其中NK/T有效率71.4%(5/7),CR率57.1%(4/7);PTCL-U有效率100.0%(6/6),CR率为50.0%(3/6);ALCL有效率80.0%(4/5),CR率为40.0%(2/5)。初治者有效率84.6%(11/13),CR率为61.5%(8/13);复治者有效率85.5%(6/7),CR率为28.5%(2/7)。21例患者共实施70个疗程化疗,主要不良反应为骨髓抑制,其中Ⅲ～Ⅳ度粒细胞减少为34.3%,40个疗程需G-CSF支持。
BACKGROUND &OBJECTIVES: The biological behavior of peripheral T cell lymphoma (PTCL) are different from that of B cell non Hodgkin’s lymphoma (NHL). It shows low chemosensitivity,high incidence of relapse, poor prognosis, and has no standard chemotherapy regimen. The efficacy of CHOP is poor for PTCL. This study was to evaluate the efficacy and toxicity of EPOCH regimen for PTCL. METHODS:EPOCH regimen(doxorubicin/epirubicin, vincristine, etoposide over 96 hours’infusion with bolus cyclophosphamide,and oral prednisone)was administered to 21 patients with PTCL. According to WHO classification criteria, 21 cases of PTCL concluded 7 peripheral T cell lymphoma unspecified (PTCL U), 7 NK/T cell lymphoma (NK/TCL), 5 anaplastic large cell lymphoma (ALCL), 1 Mycosis fungoides/Sézary syndrome (MF/SS), and 1 subcutaneous panniculitis like T cell lymphoma (SPTCL). Among them there were 14 previously untreated patients, 7 pretreated and recurrent patients. Median cycles of EPOCH regimen administered were 3 (ranged from 1 to 7 cycles). RESULTS: Of 21 patients, 20 were eligible to evaluate treatment efficacy. The response rate (RR) for the whole group was 85%(17/20)with complete remission (CR)rate of 50%(10/20). The RRs of patients with NK/TCL, PTCL U, and ALCL were 71.4%(5/7), 100.0%(6/6), and 80.0%(4/5); the CR rates were 57.1%(4/7), 50.0%(3/6), and 40.0%(2/5). The RR of patients which havent been pretreated was 84.6%(11/13), the CR rate was 61.5%(8/13); While the RR of pretreated patients was 85.5%(6/7), the CR rate was 28.5%(2/7). Seventy cycles of chemotherapy were administered to 21 patients. Major toxicity was myelosuppre ssion, the incidences of grade Ⅲ Ⅳneutropenia, thrombocytopenia, and anemia were 34.3%, 14.3%, and 7.1%. Other toxicities were mild, no treatment related mortality occurred. CONCLUSION: EPOCH was effective and well tolerant for the patients with PTCL.
出处
《癌症》
SCIE
CAS
CSCD
北大核心
2004年第8期943-946,共4页
Chinese Journal of Cancer
关键词
淋巴瘤
联合化疗
持续灌注
Peripheral T-cell lymphoma
Combined chemotherapy
Continuous infusion
