Hyper-CVAD/MA 方案和EPOCH 方案治疗外周T 细胞淋巴瘤的临床疗效比较

目的：观察和比较Hyper-CVAD/MA方案和EPOCH方案治疗外周T细胞淋巴瘤临床疗效和不良反应。方法选择54例外周T细胞淋巴瘤患者为研究对象,随机分为治疗组（29例）和对照组（25例）。治疗组给予Hyper-CVAD/MA方案治疗,对照组采用EPOCH方案治疗。治疗6-8个周期后,比较两组患者的近期疗效、不良反应的发生情况及3年生存率。结果治疗组CR 72.4％,RR 93.1％,3年生存率55.2％;对照组CR 44.0％, RR 84.0％,3年生存率28％。治疗组的完全缓解率和3年生存率显著高于对照组。两组患者的不良反应包括骨髓抑制、感染、胃肠道反应、发热、肝功能损害、神经毒性等。其中,治疗组和对照组发热的发生率分别为34.5％和4％,Ⅲ、Ⅳ级粒细胞下降的发生率分别为100％和24％,Ⅲ、Ⅳ级血小板下降的发生率分别为75.9％和12％,治疗组均显著高于对照组（P〈0.05）。两组其它不良反应的发生率比较,差异均无统计学意义（P〉0.05）,且均无化疗相关死亡病例。结论 Hyper-CVAD/MA方案治疗外周T细胞淋巴瘤的临床疗效优于EPOCH方案,且安全性尚可。

Comparison of the Clinical Efficacy of Hyper-CVAD/MA Regimen and EPOCH Regimen in the Treatment of Peripheral T-cell Lymphoma

Objective To compare the therapeutic efficacies and adverse reactions of Hyper-CVAD/MA regimen and EPOCH regimen in the treatment of peripheral T-cell lymphoma. Methods The 54 selected patients with peripheral T-cell lymphoma were randomly divided into trial group （29 cases） and control group （25 cases）. The trail group received the chemo-therapy of Hyper-CVAD/MA regimen, while the control group received the chemotherapy of EPOCH regimen. After 6-8 circles＇ treatment, the therapeutic efficacies, incidence rates of adverse reactions and 3-year survival were compared between the two groups. Results In the trail group, the complete remission ratio （CR） was 72.4%, overall response rate （RR） was 93.1%, and the 3-year survival rate was 55.2%. While in the control group, the CR, RR, 3-year survival rate were respectively 44.0%, 84%and 28.0%. The complete remission ratio and 3-year survival rate of trail group were significantly higher than those of the control group （P〈0.05）. The major adverse reactions included myelosuppression, infection, gastrointestinal reaction, fever, liver dysfunction and neurovirulence, etc. The incidence rate of fever,Ⅲ-Ⅳleukocytopenia,Ⅲ-Ⅳthrombocytopenia in trail group （respectively 34.5%, 100%and 75.9%） were significantly higher than those of the control group （respectively 4%, 24%and 12%） （P〈0.05）. No statistical differences were found between the two groups in other adverse reactions. In addition, there were no chemotherapy-related death cases. Conclusion The clinical efficacy of Hyper-CVAD/MA regimen was superior to that of EPOCH regimen for patients with peripheral T-cell lymphoma.