摘要
目的 比较含吉西他滨的联合方案和CHOP样联合方案一线治疗结外NK/T细胞淋巴瘤的效果及安全性.方法 回顾性分析河南省人民医院2012年3月至2017年3月39例初治结外NK/T细胞淋巴瘤患者,其中11例采用含吉西他滨联合方案,28例采用CHOP样联合方案.比较两组的完全缓解（CR）率、部分缓解（PR）率、总反应率（ORR）、总生存（OS）率、无进展生存（PFS）率及不良反应.结果吉西他滨组CR 5例,PR 3例;CHOP样组CR 8例,PR 5例;两组CR率和ORR比较,差异均无统计学意义（P=0.453,P=0.073）;两组预计3年OS率（75%比33%）、3年PFS率（70%比29%）比较,差异均有统计学意义（χ^2=5.606,P=0.018;χ^2=3.924,P=0.048）.单因素分析结果显示,治疗方案（P=0.018）、乳酸脱氢酶（LDH）升高（P=0.007）影响患者生存预后（均P〈0.05）.多因素分析结果显示,LDH升高增加患者的死亡风险（RR=6.331,95%CI2.339～17.136,P〈0.001）,采用含吉西他滨方案治疗降低患者的死亡风险（RR=0.101,95%CI0.023～0.452,P=0.003）.不良反应多为1～2级,患者耐受性良好.结论 含吉西他滨联合方案较CHOP样联合方案可延长结外NK/T细胞淋巴瘤患者的生存时间,提高远期疗效.
Objective To compare the efficacy and safety of combined regimen of gemcitabine and CHOP-like regimen as the first-line treatment for primary extranodal NK/T-cell lymphoma. Methods A retrospective analysis was carried out in 39 newly treated patients with extranodal NK/T-cell lymphoma in Henan Provincial People＇s Hospital from March 2012 to March 2017, in which 11 patients were treated with gemcitabine regimen and 28 patients were treated with CHOP-like regimen. The complete remission （CR） rate, partial remission （PR） rate, overall remission rate （ORR）, overall survival （OS） rate, progression free survival （PFS） rate, and adverse reactions in the two groups were compared. Results In gemcitabine group and CHOP-like group, there were 5 and 8 cases achieved CR, 3 and 5 cases achieved PR. There was no statistically significant difference in CR rates and ORR between the two groups （P= 0.453, P= 0.073）. The estimated 3-year OS rate in the two groups were 75 % and 33 %, and the estimated 3-year PFS rate were 70%and 29%, respectively. There was statistically significant differences in OS and PFS between the two groups （χ^2 = 5.606, P= 0.018; χ^2 = 3.924, P= 0.048）. The univariate analysis showed that the treatment program （P=0.018） and the high lactate dehydrogenase （LDH） （P= 0.007） affected the prognosis of patients. Multivariate analysis showed that the high LDH increased the risk of death in patients （RR= 6.331, 95% CI 2.339-17.136, P〈 0.001）. Treatment with gemcitabine regimen reduced the risk of death in patients （RR=0.101, 95 %CI 0.023-0.452, P= 0.003）. Most of the adverse events were 1-2 levels, and the patients were well tolerated. Conclusion Compared with CHOP-like regimen, the combined regimen of gemcitabine can improve the survival time of the patients with extranodal NK/T-cell lymphoma and significantly improve the long-term efficacy.
作者
王苹
袁晓莉
姜丽
杨靖
郭建民
张茵
朱尊民
Wang Ping;Yuan Xiaoli;Jiang Li;Yang Jing;Gwo Jianmin;Zhang Yin;Zhu Zunmin(Department of Hematology,Henan Provincial People＇ s Hospital,Zhengzhou 450003,Chin;Institute of Hematology,Henan Provincial People＇s Hospital,Zhengzhou 450003,China)
出处
《白血病．淋巴瘤》
CAS
2018年第6期344-347,352,共5页
Journal of Leukemia & Lymphoma
