【摘要】 目的比较FND(氟达拉滨+米托蒽醌+地塞米松)与CHOP方案治疗进展期惰性淋巴瘤的疗效与安全性。方法临床观察的终点包括缓解率(总有效率OR和完全缓解率CR),无失败生存(FFS),总体生存(OS)及毒性。40例病人随机分组,FND和CHOP组各20例。两种治疗方案均为每28天1次,共3个疗程,之后,二组病人均采用CHOP方案巩固3个疗程。FND方案为氟达拉滨25mg/m2,ivd1~5;米托蒽醌10mg/m2,ivd1;地塞米松20mg/d,ivd1~5。CHOP方案为环磷酰胺600mg/m2,ivd1;阿霉素25mg/m2,ivd1;长春新碱1.4mg/m2,ivd1和强的松50mg/m2,pod1~5。结果FND方案的完全缓解率和总有效率显著优于CHOP(OR83%vs40%,CR50%vs15%;P<0.01)。FND组的中位FFS是32个月,而CHOP组仅为15个月。两种治疗方案的耐受性均较好,只有少量的感染并发症发生。结论FND方案的完全缓解率、总有效率均显著优于CHOP,并可有效改善预后。更多还原

【Abstract】 Objective: This study compared the efficacy and safety of fludarabine-mitoxantrone-dexamethason (FND) with CHOP regimen (cyclophosphamide doxorubicin, vincristine, prednisone) in patients with advanced indolent non-Hodgkin’s lymphoma. Methods: End points were remission rates [overall response (OR) and complete response (CR)], failure-free survival (FFS), overall survival (OS)and toxicity. Total of 40 patients were enrolled, with 20 patients receiving FND regimen and the other 20 patients receiving CHOP regimen. Each treatment arm was given as three monthly cycles, followed by three monthly cycles of CHOP regimen therapy. FND comprised fludarabine(25 mg/m2 i.v.), days 1~5, plus mitoxantrone (10 mg/m2 i.v.), day 1 and dexamethason(20 mg/d i.v.),day1~5. CHOP cycles comprised cyclophosphamide(600 mg/m2 i.v. infusion), doxorubicin (25 mg/m2 i.v.) and vincristine (1.4 mg/m2 i.v.) on day 1, and prednisone (50 mg/m2) on days 1~5. Results: FND therapy resulted in superior remission rates (OR 83% versus 40%, CR 50% versus 15%; P< 0.01). Median FFS for FND patients was 32 months, compared with 15 months for CHOP patients. Both treatments were well tolerated, with only few infectious complications. Conclusion: FND was more effective than CHOP in achieving OR and CR, and favorably affected the outcome.更多还原