【摘要】 目的:观察美罗华(利妥昔单抗,Rituximab)联合CHOP(RCHOP)方案治疗侵袭性B细胞非霍奇金淋巴瘤的临床疗效、不良反应。方法:45例CD20阳性的B细胞非霍奇金淋巴瘤患者,随机分为RCHOP组(22例)和CHOP对照组(23例),分别采用美罗华联合CHOP和单用CHOP方案治疗。CHOP方案:环磷酰胺750mg/m2,静脉注射,d1;吡喃阿霉素40mg/m2或表阿霉素60mg/m2,静脉注射,d1;长春新碱1.4mg/m2,静脉注射,d1;强的松100mg,口服,d1～d5,每21天为1个周期、重复治疗。RCHOP方案:美罗华375mg/m2,静脉滴注,每1个周期第1天(d1);第3天开始CHOP方案,每21天为1个周期,重复治疗。全部45例患者完成4个周期化疗后进行疗效评价,随访观察生存情况。结果:RCHOP组完全缓解率(CR)为68.2%,总有效率为81.8%;CHOP组分别为34.8%、78.3%,两组CR率有显著性差异(P<0.05)。RCHOP组1年总生存率(OS)为90.9%,2年OS为81.8%,3年OS为77.3%;CHOP组分别为91.3%、69.5%、47.8%;两组患者的3年OS有显著性差异(P<0.05)。两组患者不良反应主要为轻中度骨髓抑制和胃肠道反应,不良反应发生率相近(P>0.05),均可耐受。RCHOP组6例(27.2%)出现美罗华输注相关的不良反应,经对症处理后好转。结论:美罗华联合CHOP(RCHOP)方案治疗侵袭性B细胞非霍奇金淋巴瘤疗效显著,患者耐受良好,应推荐作为首选方案。更多还原

【Abstract】 Objective:To evaluate the efficacy and toxicity of combination chemotherapy consisting of Rituximab and CHOP(R-CHOP) in patients with aggressive B-cell non-Hodgkin’s lymphoma.Methods:A total of 45 patients with histopathologically proven CD20-positive B-cell non-Hodgkin’s lymphoma were randomly assigned into the R-CHOP group(22 patients) and the CHOP group(23 patients).CHOP regimen:Cyclophosphamide 750 mg/m2 IV,Vincristine 1.4 mg/m2 IV,and Epirubicin 60 mg/m2 or Pirarubicin 40 mg/m2 IV were administered on the first day of the chemotherapy course;Prednisone 100 mg/m2 was administered orally from the first day to the fifth day;the cycle was repeated every 21 days.R-CHOP regimen:Rituximab 375 mg/mg2 was infused on the first day,CHOP was administered starting on the third day.All of the patients have received at least 4 chemotherapy cycles.The therapeutic effect was assessed.All patients were followed up.Results:The complete response rate and overall response rate were 68.2% and 81.8%,respectively,in the R-CHOP group,and 34.8% and 78.3%,respectively,in the CHOP group.The complete response rate in the R-CHOP group was significantly higher than that in the CHOP group(P<0.05).The 1-,2-and 3-year survival rates were 90.9%,81.8%,and 77.3%,respectively,in the R-CHOP group and 91.3%,69.5%,and 47.8%,respectively,in the CHOP group.The 3-year survival rate was significantly higher in the R-CHOP group than in the CHOP group(P<0.05).The major side effects in the two groups were mild to moderate myelosuppression and gastrointestinal toxicity,without a significant difference between the two groups(P>0.05).Rituximab infusion-induced adverse effects occurred in 6 patients(27.2%) in the R-CHOP group.Conclusion:Combination chemotherapy including Rituximab and CHOP(R-CHOP) is recommended as the preferred treatment for B-cell non-Hodgkin’s lymphoma because it is effective and well-tolerated by the patients.更多还原