HEPP方案治疗难治性非霍奇金淋巴瘤的临床观察

 目的 观察由羟基喜树碱（HCPT）为主，联合依托泊苷（VP16）、顺铂（PDD）和泼尼松（PDN）组成的HEPP方案治疗难治性非霍奇金淋巴瘤（NHL）的客观疗效和毒副反应。方法 全组25例NHL患者，男性16例，女性9例，中位年龄55岁，均为复治病例。采用HEPP方案，即HCPT 8 mg／m2，静脉滴注，第1 ~ 5天；VP16 100 mg／d，静脉滴注，第1 ~ 5天，PDD 20 mg／d，静脉滴注，第1 ~ 5天，PDN 60 mg／m2，口服，第1 ~ 14天。28 d为1个周期，连续用药2个周期以上，按WHO标准评价近期疗效，并每周期观察毒副反应。结果 全组25例中，可以评价疗效的22例，获得完全缓解（CR）3例，部分缓解（PR）10例，稳定（SD）6例，进展（PD）3例，总有效率（CR+PR）60.0 %。中位肿瘤进展时间（TTP）为6个月。血液学毒性是该方案的主要毒副反应，白细胞下降的发生率为48.0 %，其中Ⅲ／Ⅳ度占24.0 %；血小板下降的发生率为20.0 %，Ⅲ／Ⅳ度占12.0 %。恶心、呕吐反应多为Ⅰ／Ⅱ度，口腔炎、肝功能异常、便秘给予相应处理后均能在短期恢复。结论 HEPP方案治疗难治性NHL的近期疗效满意，毒副作用可耐受，值得临床进一步观察使用。

Clinical observation of HEPP regimen in treatment of refractory Non-Hodgkin lymphoma

Objective To observe the short-term efficacy and toxicity of HEPP regimen in treatment of refractory Non-Hodgkin's Lymphoma. Methods HEPP regimen: HCPT 8 mg/m2 iv gtt d1~ d5, VP16 100 mg/d iv gtt d1~d5, PDD 20 mg/d iv gtt d1~d5, PDN 60 mg/m2 po d1~d14. The chemotherapy was repeated every 4 weeks as a cycle.The clinical effect was evaluated after 2 cycles and toxicity was observed during every cycle. Results 25 patients were eligible for toxicity evaluation and 22 patients for clinical response evaluation. The objective response rate was 60.0 %, including three cases complete remission and ten cases partial remission. Six cases achieved stable disease and three cases progressive disease. The major toxicity was bone marrow suppression, including 24.0 % grade Ⅲ/Ⅳ leukopenia and 12.0 % grade Ⅲ/Ⅳ thrombocytopenia. The incidence of nausea/vomiting, mucositis and hepatic toxicity was low. Conclusion HEPP regimen can achieve a satisfy result in the treatment of refractory Non-Hodgkin's Lymphoma. It is low toxic and well tolerated.