【摘要】 目的探讨初治的霍奇金淋巴瘤(HL)更为安全有效的化疗方案。方法对2000年10月至2005年10月收治的Ⅱ～Ⅳ期HL患者97例,采用随机分组的方法分为A、B两组。A组48例,采用ABVD方案(多柔比星+博莱霉素+长春新碱+氮烯咪胺)化疗8个周期;B组49例,前4个周期采用ABVD方案化疗,后4个周期采用COEP方案(环磷酰胺+长春新碱+依托泊苷+泼尼松)化疗。两组患者化疗结束后均由同一位放疗科医师根据具体情况给予放疗,制定放疗方案时不受A、B分组的影响。结果A组8个周期ABVD方案化疗结束后完全缓解(CR)率为87.5%(43/48),1、2、3年总生存率分别为:95.8%(46/48),90.0%(36/40),79.3%(23/29)。B组8个周期化疗结束后CR率为89.8% (44/49),1、2、3年总生存率分别为:93.9%(46/49),92.7%(38/41),80.0%(24/30)。A、B两组比较,CR率1、2、3年总生存率差异均无统计学意义。A、B两组比较,B组患者心肌损伤、肺纤维化发生率差异有统计学意义。结论HL采用COEP方案4个周期、ABVD方案4个周期序贯化疗较单用ABVD方案8个周期化疗的缓解率和疗效相似,而B组心肌损害、肺纤维化的发生率减低。更多还原

【Abstract】 Objective To explore more safe and effective chemotherapy regimen of initial Hodgkin lymphomas (HL).Methods 97 patiesnts of HL in stagesⅡ～Ⅳtreated in our department during October 2000 to October 2005 were randomly divided into A and B groups.48 patients of A group received chemotherapy 8 cycles by ABVD(adriamyein,bleomycin,vincristine,dacarbazinum) regimen.49 patients of B group received COEP(cyclophosphamide,vincristine,etoposide,prednisone) regimen for 4 cycles and then ABVD regimen for 4 cycles.The patients of A and B groups were received radiotherapy by the same doctor after chemotherapy according to patients’ particular conditions,and radiotherapy regimens weren’t affect by A,B groups.Results The complete remission(CR) rate of A group after 8 cycles chemotherapy was 87.5 %(43/48),the overall survival(OS) rates of one year,two year,three year is95.8 %(46/48),90.0 % (36/40),79.3 %(23/29)respectively.The CR rate of B group after 8 cycles’ chemotherapy was CR 89.8 % (44/49),the OS rates of one year,two year,three year is 93.9 %(46/49),92.7 %(38/41),80.0 %(24/30)re- spectively.The CR rates discrepancy and the OS rates discrepancy of one year,two year,three year between A,B groups are nosignifieant.The myocardium injure and lung fibroplasias rates discrepancy between A,B groups are significant.Conclusion The CR rate and curative effect of COEP 4 cycles and then ABVD 4 cy- cles regimen are the same as CHOP 8 cycles regimen for NHHL in stagesⅡ～Ⅳ.And further,The myocardium injure and lung fibroplasias rates of A group are obviously lower than that of B group.更多还原