增强剂量CTOP方案治疗侵袭性淋巴瘤的5年生存分析

目的：分析增强剂量CTOP方案治疗侵袭性非霍奇金淋巴瘤（non-Hodgkin＇s lymphoma，NHL）的疗效及生存期情况，探讨提高吡柔比星（pirarubicine，THP）在联合化疗方案中的剂量强度后患者的生存情况。方法：38例初治侵袭性NHL随机分为2组，分别接受常规剂量CTOP（THP40mg／m^2）和增强剂量CTOP（THP60mg／m^2）方案化疗至少2个疗程，观察疗效及不良反应，收集这部分患者的5年生存数据，进行统计分析。结果：增强剂量CTOP与常规剂量CTOP方案相比，在不增加心脏毒性、脱发及骨髓抑制等不良反应的前提下，近期疗效及生存率有所改善。常规剂量组和增强剂量组1、3、5年生存率分别为94．7％、47．4％、5．3％和84．2％、63．2％、10．5％；1、3、5年无进展生存率分别为84．2％、42．1％、5．3％和78．9％、57．9％、10．5％。2组中位至疾病进展时间分别为11和13个月（P=0．6681）。结论：增强剂量CTOP方案（增强THP剂量）治疗NHL，有可能提高肿瘤完全缓解率（P值未显示统计学差异）及生存率，而且不加重不良反应。

Five-year survival analysis of patients with non-Hodgkin''''s lymphoma treated with escalated CTOP regimen

Objective: To evaluate the efficacy of escalated CTOP regimen in the treatment of infiltrative non-Hodgkin's lymphoma (NHL) and investigate the survival period of patients after increasing the dosage of pirarubicine (THP) in the combined chemothe-rapy regimen.Methods:Thirty-eight patients with chemo naive NHL were randomly divided into 2 groups. One group received conventional CTOP regimen (n=19, THP 40 mg/m2) and the other group received escalated CTOP regimen (n=19, THP 60 mg/m2) from August 2001 to May 2003. The regimen was repeated for at least 2 cycles. The response and side effect were observed and recorded. The five-year survival data were collected and analyzed. Results: Escalated CTOP achieved better complete remission rate and higher survival rate compared with conventional CTOP regimen. The 1-, 3-, 5-year survival rates were 94.7%, 47.4% and 5.3% in escalated CTOP group and 84.2%, 63.2%, and 10.5% in conventional CTOP group,respectively. The 1-, 3-, 5-year disease-free survival rates were 84.2%, 42.1%, and 5.3% in escalated CTOP group and 78.9%, 57.9%, and 10.5% in conventional CTOP group,respectively. The median progression time was 13 months for escalated CTOP group and 11 months for conventional CTOP group. The escalated CTOP regimen did not increase the side effects such as cardiotoxicity, hair loosing, and myelosuppression compared with conventional CTOP regimen (P=0.6681). There is no significant difference between these two protocols. Conclusions:The escalated CTOP regimen (increasing the dose of THP) effectively increases short-time efficacy and survival rate and does not severer side effects.