小剂量硼替佐米联合化疗治疗多发性骨髓瘤的临床研究

目的观察小剂量硼替佐米联合地塞米松、吡喃阿霉素及沙利度胺（DTT）方案与常规剂量硼替佐米联合地塞米松及沙利度胺（tha-lidomide,DT）方案治疗初发多发性骨髓瘤（multiple myeloma,MM）患者的疗效及不良反应,为多发性骨髓瘤治疗方案的临床应用提供理论依据。方法 57例MM患者分为病例组（29例）和对照组（28例）,分别给予小剂量硼替佐米（1.0 mg/m2）联合DTT方案和常规剂量硼替佐米（1.3 g/m2）联合DT方案。评价疗效及不良反应。结果 57例患者完成3个疗程治疗,病例组中23例有效,有效率79.2%;对照组中22例有效,有效率78.5%。两组疗效比较,差异无统计学意义（P〉0.05）。出现的不良反应包括白细胞减少、血小板减少、周围神经病变、感染及腹泻等,大多不良反应均在对症处理或停药后缓解或消退,两组不良反应的发生率比较,差异无统计学意义（P〉0.05）。结论小剂量硼替佐米联合DTT方案是治疗MM的一种安全有效且经济的治疗方法。

Efficacy of Low-dosage Bortezomib Combination with Dexamethasone,THP and Thalidomide for Multiple Myeloma

Objective To compare the efficacy and side effects in low-dose bortezomib combination with dexamethasone, THP and tha-lidomide （DTT） for the treatment of patients with multiple myeloma （MM）, and provide the theoretical basis for the treatment of MM. Methods A total of 57 patients with MM were divided into lowdosage group （29 cases） and control group （28 cases） , treated with lowdosage bortezomib （l.0 mg/m^2） combination with DTT and regu lardosage bortezomib （1.3 mg/m^2） combination with DT, respectively. The efficacy and adverse reaction were evaluated. Results A total of 57 patient completed 3 course of chemotherapy. The response rate was 79.2% （23 cases） in lowdosage group. The response rate was 78.5% （22 cases） in control group, not significantly different between two groups （P〉0.05） . The adverse events were thrombocytopenia, fatigue, peripheral neuropathy, infection and diarrhea. All the adverse events could be relieved by symptomatic treatment or bortezomib reduction and there was no difference between two groups （P〉0.05） .Conclusion The chemotherapy of low-dose bortezomib combination with DTT in patients with multiple myeloma is safe, effective and economical.