【摘要】 目的比较美罗华联合CHOP方案和单用CHOP方案治疗Ⅲ、Ⅳ期弥漫大B细胞性淋巴瘤(DLBCL)的疗效、生存率和不良反应。方法采用同期(2008年1月至2010年9月)非随机对照的方法,将56例弥漫大B细胞性淋巴瘤患者分为2组,美罗华联合CHOP治疗组(R-CHOP组)26例,CHOP治疗组(CHOP组)30例,比较2组患者的疗效、生存率、无进展生存率及不良反应。结果 R-CHOP组患者完全缓解15例,部分缓解8例,总有效率为88.5%(23/26);CHOP组完全缓解11例,部分缓解8例,总有效率为63.3%(19/30),2组疗效比较差异有统计学意义(P=0.036);R-CHOP组和CHOP组1年总生存率分别为96.1%和76.7%,差异有统计学意义(P=0.041),1年无进展生存率分别为80.8%和56.7%,差异有统计学意义(P=0.049)。2组患者的不良反应主要为胃肠道反应、轻中度骨髓抑制和输液相关不良反应,不良反应发生率相近,分别为38.5%和33.3%,差异无统计学意义(P>0.05)。结论美罗华联合CHOP方案能够提高治疗弥漫大B细胞性淋巴瘤患者的疗效,而不良反应未见明显增加,可作为该病的一线治疗方案。更多还原

【Abstract】 Objective To compare the effect and safety of rituximab plus CHOP(R-CHOP) and CHOP regimen on patients with stage Ⅲ and Ⅳ diffuse large B-cell lymphoma(DLBCL).Methods A total of 56 patients with Stage Ⅲ and Ⅳ DLBCL were non-randomly divided into two groups:26 patients were treated with R-CHOP,the others with CHOP.NHL international efficacy assessment and WHO criteria were used to assess the therapeutic and the adverse effects respectively.Results The overall response rate of R-CHOP group was 88.5%,including 15 complete remissions(CR) and 8 partial remissions(PR),and that of the CHOP group was 63.3% with 11 CR and 8 PR.The response rate was significantly higher in R-CHOP group than that in CHOP group(P =0.036).The one-year survival rate was 96.1% in R-CHOP group and 76.7% in CHOP group,respectively.The one-year progression-free survival(PFS) rates were 80.8% and 56.7%,respectively.There were significant differences between one-year survival rates and PFS rates in two groups(P < 0.05).The major side effects in both regimens were gastrointestinal toxicity,mild to moderate myelosuppression,and adverse reactions to transfusion with no significant difference(P > 0.05).Conclusion Compared with CHOP,R-CHOP regimen increases the therapeutic efficacy in patients with stage Ⅲ and ⅣDLBCL,and has no significant increase in toxicity.R-CHOP regimen should be applied to the first line chemotherapy.更多还原