158例肾母细胞瘤治疗与预后因素分析

目的 探讨增强剂量ＣＨＯＰ方案治疗非霍奇金淋巴瘤的临床完全缓解率和３年生存率及骨髓抑制等情况。方法 对５１例非霍奇金淋巴瘤患者进行增强剂量ＣＨＯＰ方案治疗及良好的支持治疗并长期、定期治疗及随访。结果 全组完全缓解率为７８．４％；３年生存率为７７．９％。结论 增强剂量ＣＨＯＰ方案与传统ＣＨＯＰ方案相比在完全缓解率和３年生存率上有明显提高，而其骨髓抑制等毒副反应未见明显增加。     

吡喃阿霉素为主增强剂量TCOP方案治疗非霍奇金淋巴瘤的临床观察

目的：探讨吡喃阿霉素为主增强剂量ＴＣＯＰ方案,治疗非霍奇金淋巴瘤的临床完全缓解率和３ 年生存率及骨髓抑制和心脏毒性等情况。方法：对２２ 例非霍奇金淋巴瘤患者进行吡喃阿霉素为主增强剂量ＴＣＯＰ方案治疗及良好的支持治疗并长期、定期治疗及随访。结果：全组完全缓解率为８６４ ％ ;１ 年生存率为９５５ ％ ,３ 年生存率为７３１％ 。骨髓抑制及心脏毒性等毒副反应未见明显增加。结论：吡喃阿霉素为主增强剂量ＴＣＯＰ方案与传统ＣＨＯＰ方案相比在完全缓解率和３ 年生存率上有明显提高而其骨髓抑制及心脏毒性等毒副反应未见明显增加     

MACOP方案治疗非霍奇金淋巴瘤

34例非霍奇金淋巴瘤患者随机分为两组（各17例），分别采用CHOP方案及CHOP方案基础上加用中剂量甲氨喋呤（MTX）及甲酰四氢叶酸钙（CF）解救进行治疗（MACOP方案）。结果MACOP组及CHOP组的CR率分别52．9％和23．5％，RR率分别为76．5％和58．8％。两组方案的Ⅲ-Ⅳ度骨髓抑制MACOP组比CHOP组明显，MACOP组口腔溃疡的发生率明显高于CHOP组（P＜0．05），余无明显差异。     

高剂量强度环磷酰胺治疗非霍奇金淋巴瘤的Meta分析

目的 评价高剂量强度环磷酰胺治疗非霍奇金淋巴瘤的疗效.方法 计算机检索PubMed、Medline、Embase、Cochrane图书馆、CBM、VIP和CNKI数据库,检索时间至2013-12.纳入以CHOP(环磷酰胺、多柔比星、长春新碱、泼尼松)化疗方案为对照组,且试验组加用环磷酰胺[剂量强度＞250mg/(m2·周)]的相关研究,评价纳入研究的方法学质量,并提取资料,用Stata 11.0软件对数据进行Meta分析.结果 共纳入9篇随机对照试验,3 509例患者.Meta分析显示,高剂量强度环磷酰胺的方案较标准CHOP的5年总生存率(SHR=0.83,95 ％CI为0.73～0.94)、5年无事件生存率(SHR=0.80,95％CI为0.72～0.89)、完全缓解率(SOR=0.70,95％CI为0.63～0.77),差异均有统计学意义(P值均＜0.05),此获益在中高危或预后差的非霍奇金淋巴瘤患者中更加显著.结论 高剂量强度环磷酰胺联合CHOP方案较CHOP方案可改善非霍奇金淋巴瘤患者的5年总生存率、5年无事件生存率及完全缓解率,该方案适用于中高危或预后差的非霍奇金淋巴瘤患者,但尚需更多大样本高质量随机对照试验进一步确认.     

高剂量表阿霉素的CHOP方案治疗非霍奇金淋巴瘤

目的 :观察高剂量表阿霉素组成的CHOP方案治疗非霍奇金淋巴瘤 (NHL)的疗效及其不良反应。方法 :表阿霉素 90 5mg/m2 组成的CHOP方案治疗 30例淋巴瘤患者。结果 :完全缓解 73 3% ,部分缓解 2 6 7%。主要副反应为骨髓抑制 ,表现为白细胞下降 ,对血小板及血红蛋白的影响轻微 ;急性心脏毒性不明显 ,未见其它严重不良反应。结论 :以高剂量表阿霉素组成的CHOP方案治疗NHL疗效高、安全性好     

美罗华联合CHOP方案治疗侵袭性B细胞淋巴瘤45例临床疗效观察

目的：观察美罗华（利妥昔单抗，Rituximab）联合CHOP（RCHOP）方案治疗侵袭性B细胞非霍奇金淋巴瘤的临床疗效、不良反应。方法：45例CD20阳性的B细胞非霍奇金淋巴瘤患者，随机分为RCHOP组（22例）和CHOP对照组（23例），分别采用美罗华联合CHOP和单用CHOP方案治疗．CHOP方案：环磷酰胺750mg／m^2．静脉注射，d1；吡喃阿霉素40mg／m^2或表阿霉素60mg／m^2，静脉注射，d1；长春新碱1．4mg／m^2，静脉注射，d1；强的松100mg．口服，d1～d5，每21天为1个周期、重复治疗。RCHOP方案：美罗华375mg／m^2，静脉滴注，每1个周期第1天（d1）；第3天开始CHOP方案，每21天为1个周期，重复治疗。全部45例患者完成4个周期化疗后进行疗效评价．随访观察生存情况。结果：RCHOP组完全缓解率（CR）为68．2％，总有效率为81．8％；CHOP组分别为34．8％、78．3％，两组CR率有显著性差异（P〈0．05）。RCHOP组1年总生存率（OS）为90．9％，2年OS为81．8％．3年OS为773％；CHOP组分别为91.3％、69．5％、47．8％；两组患者的3年OS有显著性差异（P〈0．05），两组患者不良反应主要为轻中度骨髓抑制和胃肠道反应，不良反应发生率相近（P〉0．05），均可耐受。RCHOP组6例（27．2％）出现美罗华输注相关的不良反应．经对症处理后好转。结论：美罗华联合CHOP（RCHOP）方案治疗侵袭性B细胞非霍奇金淋巴瘤疗效显著，患者耐受良好．应推荐作为首选方案．     

75例鼻咽非霍奇金淋巴瘤临床分析

背景和目的：鼻咽是较常见的非霍奇金淋巴瘤结外侵犯部位,但其标准的治疗方法目前仍未确定,本文拟分析有关资料,探讨鼻咽非霍奇金淋巴瘤的临床特征及治疗策略。方法：收集1976年6月至2001年8月在中山大学肿瘤医院收治的75例鼻咽非霍奇金淋巴瘤患者的临床资料。回顾性分析其临床特点和治疗方式对患者生存期的影响。结果：鼻咽非霍奇金淋巴瘤临床分期大多为I－II期（占90．9％）,病理类型按工作分型多为中度恶性（占95．2％）,免疫分型以B细胞为主（占68．6％）,本组患者采用化放疗联合治疗47例（62．7％）,单纯化疗19例（25．3％）,单纯放疗9例（12．0）％,总的2、5 和10年生存率分别为79．1％,69．8％和64．3％,正规CHOP方案化疗加或不加局部放疗者54例,总的2、5和10年生存率均为84．6％。然而,单纯局部放疗患者生存率低,5年生存率为0,CHOP方案化疗加或不加局部放疗者,5年生存率无显著性差异（74．1％vs77.0%),局部放射剂量≤50Gy者与＞50Gy者5年生存率亦无显著性差异（60．0％vs 58.7%)。结论：鼻咽非鼻奇金淋巴瘤在治疗上应以含CHOP方案的全身化疗为主,是否需要加用局部放疗以及最佳放射剂量,尚需前瞻性随机研究证实。     

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。     

改良的ProMACE／CytaBOM方案治疗非霍奇金淋巴瘤的疗效观察

目的：探讨改良的ProMACE／CytaBOM方案治疗高度恶性非霍奇金淋巴瘤及中度恶性非霍奇金淋巴瘤的疗效。方法：采用改良的ProMACE／CytaBOM方案治疗16例高度恶性非霍奇金淋巴瘤及中度恶性非霍奇金淋巴瘤患者，其中高度恶性9例，7例为初发患者，2例为复发患者；中度恶性7例为复发患者。结果：7例高度恶性非霍奇金淋巴瘤及中度恶性复发性非霍奇金淋巴瘤达到完全缓解（CR率4．3．7％），6例达到部分缓解（PR率37．5％），总有效率为81．2％；目前8例仍生存，其中生存时间最长达42个月（2例），仍处于CR期。毒副作用主要为消化道症状、轻度肝功能异常以及骨髓抑制。结论：改良的ProMACE／CytaBOM方案对部分高度恶性非霍奇金淋巴瘤及中度恶性复发性非霍奇金淋巴瘤患者效果好，毒副作用较轻，值得推广使用。     

TCOP联合平阳霉素治疗中高度非霍奇金淋巴瘤的临床研究

目的:探讨TCOP-P(TCOP联合平阳霉素)方案治疗中、高危非霍奇金淋巴瘤的疗效.方法:将66例患者随机分为两组.TCOP-P方案35例(A组)和CHOP方案31例(B组).每21天重复疗程,全部患者接受6～8个周期治疗.结果:A组完全缓解(CR)、总有效率、3年生存率分别为57.1%、88.5%和73.5%,均明显高于B组(P＜0.05);3年复发率和心肌损害率均明显低于B组.结论:TCOP-P方案治疗中高危非霍奇金淋巴瘤疗效明显优于CHOP方案,可以提高完全缓解率、延长生存时间、减少复发率.     

不同方案治疗中高度恶性非霍奇金淋巴瘤的临床探讨

目的寻找治疗中、高度恶性非霍奇金淋巴瘤（ＮＨＬ）完全缓解（ＣＲ）率高的最佳方案。方法将７４例组织学证实的ＮＨＬ患者随机分为两组：治疗组应用改良的ＰｒｏＭＡＣＥ—ＣｙｔａＢＯＭ方案,对照组应用ＣＨＯＰ方案。结果治疗组ＣＲ率５６．８％,对照组为３５．１％,两组差异无显著性（Ｐ＞０．０５）。治疗高度恶性ＮＨＬ治疗组ＣＲ率达６０．０％,而对照组只有３２．０％,两组差异有显著性（Ｐ＜０．０５）。两组毒副反应均为骨髓抑制及消化道反应,一般均耐受。结论治疗高度恶性ＮＨＬ,Ｐｒｏ－ＭＡＣＥ—ＣｙｔａＢＯＭ方案是一个安全且ＣＲ率高的化疗方案,其远期效果有待进一步研究。     

Observation of the Curative Effect of Mabthera in Combination with the CHOP Regimen in Treating Invasive B-Cell Lymphoma: A Report of 45 Cases

OBIECTIVE To observe the clinical efficacy and toxic effects of Mabthera(rituximab)in combination with the CHOP(R-CHOP)regimen for treating invasive B-cell non-Hodgkin's lymphoma.METHODS A total of 45 patients with CD20 positive B-cell non-Hodgkin's lymphoma were randomly divided into the R-CHOP(22 cases) and CHOP groups(23 cases for controls).They received the regimens of Mabthera in combination with CHOP or single CHOP therapy respectively.An appraisement of the curative effect could only be performed following 4 cycles of chemotherapy for the 45 patients.Follow-up was conducted to observe the conditions ot survival.RESULTS The rate of complete remission(CR)in the R-CHOP group was 68.2%,with a total effective rate of 81.8%,and in the CHOP group these rates were 34.8% and 78.3%respectively.There was a significant difference in comparing the CR rates between the two groups (P<0.05).The 1,2 and 3-year overall survival (OS) rates of the RCHOP group were 90.9%,81.8% and 77.3%,respectively.In the CHOP group,the OS rates were respectively 91.3%,69.5% and 47.8%.The difference in the 3-year OS between the two groups was significant (P<0.05).The toxic effects of the two groups were mainly a slight and moderate bone marrow depression and a gastrointesinal reaction,with similar tolerable toxic effects in the two groups (P>0.05).Adverse effects related to the Mabthera infusions occurred in 6 cases of the R-CHOP group(27.2%).These effects lessened after symptomatic treatment.CONCLUSION The therapeutic regimen Of Mabthera,in combination with CHOP(R-CHOP)has an obvious curative effect for treating invasive B-cell non-Hodgkin's lymphoma,with a favorable tolerance.It is highly recommended as the treatment ot choice.     

Non-Hodgkin's lymphoma of unfavourable histology: a multivariate analysis of factors predicting the response to CHOP

Forty-eight patients with de novo non-Hodgkin's lymphoma (NHL) of unfavourable biology received CHOP as first-line chemotherapy. A complete remission (CR) was achieved in 64.5 per cent patients. Overall 4-year projected survival was 48 per cent with a median follow-up of 40.5 months. Two pretreatment characteristics, high LDH serum levels and bulky abdominal disease, were negatively associated with survival at the proportional hazards regression model and were used to calculate each patient's relative-risk. Such analysis allowed to identify two prognostic subgroups according to their outcome to CHOP. Firstly, a high-risk subgroup that showed an 8 per cent CR rate, most patients dying within the first year after diagnosis. Secondly, a low-risk subgroup that showed an 83.5 per cent CR rate and a 4-year project survival of 66 per cent. From the above results two major conclusions can be drawn: (1) the CHOP combination is an effective treatment for unfavourable NHL patients with a low relative-risk and (2) new therapeutic approaches should be explored for NHL patients with a high relative-risk at diagnosis.     

CHEP和CHOP方案治疗非霍奇金淋巴瘤的疗效比较

目的评价ＣＨＥＰ和ＣＨＯＰ方案治疗非霍奇金淋巴瘤（ＮＨＬ）的疗效和毒性。方法１９８９年１０月～１９９６年６月应用ＣＨＥＰ方案（环磷酰胺、阿霉素、足叶乙甙、强的松）或ＣＨＯＰ方案（环磷酰胺、阿霉素、长春新碱、强的松）治疗５２例ＮＨＬ,每组２６例。疗效和毒性用卡方检验。结果ＣＨＥＰ组有效率７６．９％（２０／２６）,其中初治１０例中,完全缓解（ＣＲ）７例;ＣＨＯＰ组有效率６５．４％（１７／２６）,初治１７例中,ＣＲ８例（Ｐ＞０．０５）。随访至１９９６年８月底,ＣＨＥＰ组存活１６例,ＣＨＯＰ组存活１５例,中位生存期为２４个月和２０个月。初治ＣＲ者,１年无病生存（ＤＦＳ）率分别为７０．０％和２３．５％,差异有显著性（Ｐ＜０．０５）,２～５年ＤＦＳ率差异无显著性（Ｐ＞０．０５）。两组毒性均可耐受。结论ＣＨＥＰ治疗ＮＨＬ,初治１年ＤＦＳ率显著优于ＣＨＯＰ组（Ｐ＜０．０５）,两组毒性相似,但ＣＨＥＰ组无末梢神经毒性。     

BFM-90、CHOP和 CHOP/HD-MTX方案治疗儿童青少年 B细胞非霍奇金淋巴瘤的生存率比较

背景与目的：儿童青少年B细胞非霍奇金淋巴瘤(B cell non-Hodgkin’s lymphoma,B-NHL)恶性程度高、进展快、早期患者对常规CHOP方案化疗可获得较好疗效,但晚期患者疗效差。对不同分期的患者应如何治疗值得进一步探索。本文回顾性分析和比较CHOP、CHOP HD-MTX和德国BFM-90方案治疗儿童青少年B-NHL的疗效、不良反应和生存率。方法：CHOP方案组30例3～17岁初治的B-NHL患者,Ⅰ／Ⅱ期13例,Ⅲ／Ⅳ期(St Jude分期)17例,均接受2～8疗程常规CHOP方案化疗,每3周重复。CHOP HD-MTX组18例3～14岁初治的B-NHL患者,Ⅰ／Ⅱ期6例,Ⅲ／Ⅳ期(st Jude分期)12例,均接受2～8疗程CHOP HD-MTX方案化疗和鞘注,每4周重复。BFM-90方案组25例1．5～15岁的初治的B-NHL患者,Ⅱ期7例,Ⅲ／Ⅳ期(St Jude分期)18例,均接受NHL-BFM-90方案化疗。Ⅰ／Ⅱ期患者接受A和B疗程交替化疗共4～6疗程;Ⅲ／Ⅳ期患者接受AA和BB疗程交替化疗共6疗程,每疗程间隔18～21天。结果：CHOP组21例(70％)完全缓解(complete response,CR),4例(13％)部分缓解(partial response,PR);有20％的疗程发生Ⅲ／Ⅳ级血液毒性。CHOP HD-MTX组15例(83％)CR,3例(16％)PR;有52％疗程发生Ⅲ／Ⅳ级血液毒性。BFM-90方案组24例(96％)CR,1例(4％)PR;Ⅲ／Ⅳ级血液毒性：A疗程57％,B疗程60％,AA疗程91％,BB疗程76％;AA疗程的血液毒性明显高于其他疗程。Ⅱ／Ⅲ级粘膜炎主要发生在AA和BB疗程,占35％。三组均按Kaplan-Meier方法进行生存率统计。CHOP组2年总生存率52．79％,Ⅰ／Ⅱ期患者72．73％,Ⅲ／Ⅳ期37．82％。CHOP HD-MTX组2年总生存率55．56％,Ⅰ／Ⅱ期患者83．33％,Ⅲ／Ⅳ期41．67％。CHOP组患者生存率与CHOP HD-MTX组比较无显著性差异(P=0．78)。BFM-90方案组2年无事件生存率84．01％,Ⅰ／Ⅱ期患者100．00％,Ⅲ／Ⅳ期患者77．04％。BFM-90方案组生存率与CHOP组和CHOP HD-MTX组比较有显著性差异(P=0．013,0．034)。结论：BFM-90方案能明显提高儿童青少年B-NHL的生存率,特别是对晚期患者的疗效改善更明显。CHOP和CHOP HD-MTX对早期患者可获得较好的疗效,但对晚期患者疗效差。对晚期B-NHL应采用类似BFM-90方案的高强度化疗。     

Salvage therapy with ProMACE-MOPP followed by intensive chemoradiotherapy and autologous bone marrow transplantation for patients with non-Hodgkin's lymphoma who failed to respond to first-line CHOP.

PURPOSE: We used alternative chemotherapy immediately followed in early-response patients by high-dose chemoradiotherapy and autologous bone marrow transplantation (ABMT) to treat patients with non-Hodgkin's lymphoma (NHL) who had failed to respond to first-line chemotherapy. PATIENTS AND METHODS: Thirty-one patients with NHL of intermediate- or high-grade malignancy who had failed to respond to first-line cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) chemotherapy were treated. Seventeen patients had primary refractory disease and 14 had relapsed from first complete response (CR). The treatment consisted of prednisone, methotrexate, doxorubicin, cyclophosphamide, etoposide, mechlorethamine, vincristine, and procarbazine (ProMACE-MOPP) salvage chemotherapy, followed, in case of responsive disease (at least partial response [PR]), by high-dose cyclophosphamide and total-body irradiation (TBI) with ABMT. RESULTS: Twenty-eight of 31 (90%) patients achieved PR (23 patients) or CR (five patients) with ProMACE-MOPP, and three failed to respond. Seventeen of 28 (61%) patients who responded underwent the ABMT procedure, which resulted in CR in 14 patients (82%); three failed to respond. Eleven responsive patients were not transplanted because of residual bone marrow infiltration (five patients), patient refusal (four patients), and ProMACE-MOPP-related mortality (two patients). To date, nine patients are alive and in CR, seven with a median follow-up of 41 months (range, 17 to 84 months). Referring to the original CHOP treatment, five of 17 (29%) patients with primary refractory disease remain free of disease at a median of 36 months after ABMT, and four of 14 (29%) patients in first relapse remain free of disease at a median of 33 months after ABMT. One patient died of AMBT-related toxicity. CONCLUSION: ProMACE-MOPP salvage chemotherapy produces a high early-response rate in patients who fail to respond to first-line CHOP, and more than half of the responding patients can be scheduled to receive ABMT, resulting in disease-free survival (DFS) at 3 years in 50% of the transplanted patients and in 25% of the original number of patients intended to receive this treatment.     

Observation of the Curative Effect of Mabthera in Combination with the CHOP Regimen in Treating Invasive B-Cell Lymphoma： A Report of 45 Cases

OBJECTIVE To observe the clinical effcacy and toxic effects of Mabthera (rituximab) in combination with the CHOP (R-CHOP) regimen for treating invasive B-cell non-Hodgkin’s lymphoma. METHODS A total of 45 patients with CD20 positive B-cell non-Hodgkin’s lymphoma were randomly divided into the R-CHOP (22 cases) and CHOP groups (23 cases for controls).They received the regimens of Mabthera in combination with CHOP or single CHOP therapy respectively.An appraisement of the curative effect could only be performed following 4 cycles of chemotherapy for the 45 patients.Follow-up was conducted to observe the conditions of survival. RESULTS The rate of complete remission(CR)in the R-CHOP group was 68.2%,with a total effective rate of 81.8%,and in the CHOP group these rates were 34.8% and 78.3% respectively.There was a significant difference in comparing the CR rates between the two groups (P<0.05).The 1,2 and 3-year overall survival (OS) rates of the RCHOP group were 90.9%,81.8% and 77.3%,respectively.In the CHOP group,the OS rates were respectively 91.3%,69.5% and 47.8%.The difference in the 3-year OS between the two groups was significant (P<0.05).The toxic effects of the two groups were mainly a slight and moderate bone marrow depression and a gastrointesinal reaction,with similar tolerable toxic effects in the two groups (P>0.05). Adverse effects related to the Mabthera infusions occurred in 6 cases of the R-CHOP group (27.2%).These effects lessened after symptomatic treatment. CONCLUSION The therapeutic regimen of Mabthera,in combination with CHOP (R-CHOP) has an obvious curative effect for treating invasive B-cell non-Hodgkin's lymphoma,with a favorable tolerance.It is highly recommended as the treatment of choice.     

Infusional CHOP chemotherapy (CVAD) with or without chemosensitizers offers no advantage over standard CHOP therapy in the treatment of lymphoma: a Southwest Oncology Group Study.

PURPOSE: Two phase II studies were conducted to evaluate infusional cyclophosphamide, doxorubicin, vincristine, and dexamethasone chemotherapy, termed the CVAD regimen, alone (Southwest Oncology Group [SWOG] 9240) and with the chemosensitizers verapamil and quinine (SWOG 9125) to assess effects on response, survival, and toxicity in intermediate- and high-grade advanced-stage non-Hodgkin's lymphoma (NHL). The results were compared with the historic group of patients randomized to CHOP chemotherapy on Intergroup (INT) 0067 (SWOG 8516). PATIENTS AND METHODS: All patients had biopsy-proven intermediate- or high-grade NHL (lymphoblastic histology excluded), were ambulatory and previously untreated, and had bulky stage II, III, or IV disease. One hundred twelve patients were registered on SWOG 9240 and received cyclophosphamide 750 mg/m(2) by intravenous bolus day 1, doxorubicin 12.5 mg/m(2)/d and vincristine 0.5 mg/d delivered as a continuous 96-hour infusion on days 1 through 4, and dexamethasone 40 mg/d orally on days 1 through 4 (CVAD). Cycles were repeated every 21 days for eight cycles. One hundred patients on SWOG 9125 received the same chemotherapy and the chemosensitizers verapamil 240 mg bid and quinine 40 mg tid. Chemosensitizers were begun 24 hours before chemotherapy and continued for a total of 6 days. RESULTS: Eighty-one patients were eligible for each study. The complete response (CR) rates were 39% on SWOG 9125 and 31% on SWOG 9240. With a median follow-up of 5.8 years on SWOG 9125 and 4.5 years on SWOG 9240, the 2-year failure-free survival (FFS) rate was 42% on SWOG 9125 and 41% on SWOG 9240. Two-year overall survival (OS) rate was 64% on SWOG 9125 and 58% on SWOG 9240. These results are comparable to a 44% CR rate, a 2-year FFS of 46%, and 2-year OS of 63% observed in 225 patients treated with CHOP on INT 0067 (SWOG 8516). CONCLUSION: CVAD combination chemotherapy alone or with the chemosensitizers verapamil and quinine is not promising therapy with respect to improved response or OS in intermediate- and high-grade advanced-stage NHL.     

A phase II trial of adjuvant low-dose total body irradiation in non-Hodgkin's lymphoma patients following standard CHOP

Because survival results achieved in aggressive NHL with the standard CHOP are not very satisfactory, we investigated adding adjuvant low-dose total body irradiation (LTBI) to standard CHOP in a phase II trial. Thirty-six patients were included between September 1999 and September 2001. All patients were in documented complete remission (CR) after the end of their standard CHOP. LTBI started 4-6 weeks following the last CHOP course and was given in two courses, each with 4 daily fractions of 0.2 Gy, separated by 2 weeks of rest. Patients with bulky disease received involved-field radiotherapy on initial bulky sites starting 4-6 weeks after the last LTBI fraction. Primary end points were disease-free survival (DFS) and overall survival (OS) and the secondary end point was toxicity. The toxicities of LTBI were temporary thrombocytopenia and leucopenia (requiring no transfusions or treatment with growth factors). The 3-year DFS was 61%±9% and the overall survival was 87±6%. Univariate analysis showed time to achieve CR, and whether the patient got LTBI-induced haematological toxicity to be 2 significant prognostic factors affecting DFS. The use of adjuvant LTBI in patients with aggressive NHL in CR after standard chemotherapy is a feasible, non-toxic treatment that is worthy of testing in a future phase III trial.     

两周CHOP方案治疗非霍奇金淋巴瘤临床疗效观察

目的：评价两周CHOP方案治疗非霍奇金淋巴瘤（NHL）的疗效及不良反应。方法：对2000年1月至2004年10月68例非霍奇金淋巴瘤随机分为两周方案组（CHOP／2W）及三周方案组（CHOP／3W）．每组34例．全部经病理及免疫组化证实全部采用CHOP方案化疗，CTX 750mg／m^2 d1、ADM 50mg／m^2d1、VCR1．4mg/m^2d1、PDN 100mg d1-5。两周方案组，从第5天至第11天开始行G-CSF预防白细胞下降。结果：两周方案有效率为97．1％，三周方案有效率为79．4％（P〈0．05）。两组患者的不良反应均无明显差异（P〉0．05），结论：两周方案治疗NHL是一种安全、有效的治疗方案。