EPOCH方案治疗复发和耐药中高度恶性非霍奇金淋巴瘤

背景和目的：复发或耐药非霍奇金淋巴瘤（non-Hodgkin‘s lymphoma,NHL)是肿瘤化疗的难点之一,目前尚无标准的解救方案。临床前研究和临床研究均证明部分抗癌药物持续静脉灌注可提高疗效或降低毒性,本试验的目的为观察用EPOCH方案胸脉灌注治疗NHL患者的疗效和不良反应。方法：2001年6月到2002年6月共收治26例复发或耐药中高度恶性NHL,其中20例（84．7％）患者至少接受2个化疗方案的治疗,中位方案数2（1－6）个,中位疗程数8（3－16）个,15例（65．7％）患者复发耐药;采用含蒽环类药物连续静脉滴注的方案EPOCH（VP－16,EPI／ADM,VCR,CTX,Prednisone)化疗1－6个疗程（中位2个疗程）。结果：本组26例患者均可评价疗效和不良反应,总的客观有效率50％,完全缓解率19．2％,其中T细胞来源NHL有效率为28．6％,B细胞来源NHL为57．9％,26例患者共实施46个疗程化疗,主要不良反应为骨髓抑制,其中Ⅲ-Ⅳ度粒细胞减少发生率为34．8％,Ⅲ-Ⅳ度血小板减少发生率为8．7％,其他不良反应少见。结论：EPOCH是复发或耐药中高度恶性NHL经济有效的解救方案,值得进一步研究推广。     

沙利度胺联合ICE方案治疗复发性难治性非霍奇金淋巴瘤

目的:探讨沙利度胺联合ICE（异环磷酰胺、卡铂和依托铂苷）方案治疗复发性或难治性非霍奇金淋巴瘤(NHL)的疗效及不良反应。方法:25例经传统化疗方案化疗后复发或难治性NHL患者采用沙利度胺联合ICE方案化疗。化疗至少2个周期后评价疗效及不良反应。结果:25例患者中,完全缓解7例,部分缓解9例,无变化4例,进展5例,总有效率为64.0%。治疗后,血清LDH水平低于治疗前,差异有统计学意义（P<0.05）。主要不良反应为骨髓抑制,其中Ⅲ-Ⅳ度血小板减少10例,Ⅲ-Ⅳ度白细胞减少9例,Ⅲ-Ⅳ度血红蛋白减少7例,经对症治疗后未影响化疗的顺利进行。其他不良反应均属Ⅰ-Ⅱ度。结论:沙利度胺联合ICE方案治疗复发或难治性NHL疗效较好,不良反应可以耐受。     

DA-EPOCH-R方案治疗B细胞非霍奇金淋巴瘤效果观察

目的 观察DA-EPOCH-R方案治疗B细胞非霍奇金淋巴瘤(NHL)的效果及安全性.方法 采用DA-EPOCH-R方案治疗43例B细胞NHL患者,观察近期疗效、不良反应,进行随访,分析生存情况.结果 43例NHL患者共接受203个疗程化疗,中位化疗6个(2~8个)疗程.32例(74.4%)化疗2~4个疗程后达完全缓解(CR).年龄≤60岁与>60岁、 Ⅰ~Ⅱ期与Ⅲ~Ⅳ期、 生发中心来源(GCB)型与非GCB型、双表型与非双表型患者CR率差异均无统计学意义(均P>0.05).中位随访40个月(9~62个月),1、3年总生存率分别为97.6%、92.8%.不良反应为血液学不良反应,化疗结束后的随访期内未见严重不良反应,未出现继发性第二肿瘤.结论 DA-EPOCH-R方案治疗B细胞NHL CR率较高,Ⅲ、Ⅳ期患者的疗效与Ⅰ、Ⅱ期相近,老年患者耐受性良好.     

标准剂量CEOP方案治疗老年非霍奇金淋巴瘤患者的临床观察

 【摘要】　目的　分析标准剂量CEOP方案治疗老年非霍奇金淋巴瘤（NHL）患者的疗效和不良反应。方法　回顾性分析福建省立医院2009年 7月至2011年12月接受标准剂量CEOP方案±利妥昔单抗方案（环磷酰胺750 mg／m2 第1天,长春新碱2 mg 第1天,地塞米松10～15 mg 第1天至第5天,表柔吡星 60～75 mg／m2 第1天,利妥昔单抗 375 mg／m2 第0天,每周期间隔21～28 d）化疗的34例老年NHL患者的临床资料。结果　34例患者完全缓解17例,部分缓解9例,稳定3例,进展5例,总有效率为76.5 %（26／34）。主要不良反应为血液学毒性,Ⅲ～Ⅳ度粒细胞减少发生率为71.4 %（24／34）。结论　采用标准剂量CEOP方案治疗老年NHL疗效较高,心脏毒性较低,治疗耐受性良好,对一般状况良好的患者值得推荐。     

替尼泊苷与尼莫司汀联合治疗MGMT阴性表达的恶性胶质瘤：附18例经验

背景与目的：化疗是胶质瘤重要的辅助治疗方法。本研究联合替尼泊苷（VM-26）与尼莫司汀（ACNU）治疗O^6-甲基鸟嘌呤-DNA甲基转移酶（O^6-metllylguanine—DNA methyltransferase,MGMT）阴性表达的恶性胶质瘤患者,观察其疗效．评价其不良反应。方法：2006年12月至2008年12月,18例患者经手术或立体定向活检确诊为恶性胶质瘤（WHO分级为Ⅲ或Ⅳ级）,患者既往均接受过放疗,其中大多数（13例）接受过化疗后复发者。肿瘤组织免疫组织化学检测提示MGMT蛋白呈阴性表达,接受VM-26与ACNU联合方案化疗。化疗方案为VM-26,80～100mg／（m^2·d）,d1-3;ACNU,2～3mg／kg,d1,6-8周重复一次。按WHO实体瘤疗效评价标准评价疗效。按美国国立癌症研究所（National Cancer Institute,NCI）评价标准评价不良反应。结果：18例患者共行70周期化疗,平均3．9个周期（2—6个周期）。化疗的主要剂量限制性毒性为骨髓抑制,Ⅲ、Ⅳ级中性粒细胞减少症发生率分别为51．4％（36,70）、25．7％（18/70）,Ⅲ、Ⅳ级血小板减少症发生率分别为24．3％（17／70）、12．9％（9,70）。按既往是否接受化疗．患者可分为既往接受化疗组、未接受化疗组,两组间Ⅲ、Ⅳ级中性粒细胞减少症及Ⅲ、Ⅳ级血小板减少症发生率无显著性差异（均P〉0．05）。18例患者中,无完全缓解（complete response,CR）病例,1例（5．6％）部分缓解（partial response,PR）,13例（72．2％）微效（minor response,MR）,3例（16．7％）稳定（stable disease,SD）,1例（5．6％）进展（progressive disease,PD）。客观有效率（CR＋PR）为5．6％,总反应率（CR＋PR＋MR）为88．9％。疾病控制率（CR＋PR＋MR＋SD）为94．4％。从使用本方案化疗开始计算,患者中位无进展生存期（PFS）为2．6个月（95％CI：2．49—2．90）,6个月PFS％为36％;中位总生存（OS）为6．7个月（95％CI：3135—11．1）。结论：VM-2-与ACNU联合方案主要不良反应为Ⅲ、Ⅳ级骨髓抑制．但可控制。VM-26与ACNU联合方案治疗恶性脑胶质瘤．可取得较高的总反应率和疾病控制率。     

厄罗替尼治疗晚期非小细胞肺癌19例临床疗效

目的评价厄罗替尼治疗ⅢB～Ⅳ期非小细胞肺癌（NSCLC）的疗效和患者不良反应。方法19例患者均为经病理证实的、至少接受过一种方案全身化疗的晚期NSCLC患者。厄罗替尼150mg／次,1次／d,口服,直至病情进展或出现不能耐受的不良反应。采用实体瘤疗效评价标准（RECIST）评价疗效,美国国立癌症研究所毒性评价标准（CTCAE）评价不良反应。结果19例患者客观缓解率（ORR）为21．1％（4／19）。疾病控制率（完全缓解＋部分缓解＋稳定）为84．2％（16／19）,疾病无进展生存时间（PFS）3～36个月,中位PFS7．5个月;生存时间9～39个月,中位生存时间15．9个月。不良反应主要是皮疹16例（84．2％）,腹泻11例（57．9％）,多为Ⅰ～Ⅱ度;Ⅲ度丙氨酸氨基转移酶升高1例;未出现Ⅳ度药物相关不良反应。结论厄罗替尼对既往化疗失败的局部晚期或转移性NSCLC患者有较好的疗效和安全性。     

以吉西他滨为主的联合化疗方案治疗晚期乳腺癌的疗效评价

目的：评价以吉西他滨为主的联合化疗方案治疗晚期乳腺癌的疗效与不良反应。方法：对经病理确诊的Ⅳ期乳腺癌患者32例,采用以吉西他滨为主的联合化疗方案进行化疗。吉西他滨的剂量为800～1000mg／m^2,d1、d8、d15其它化疗药物采用常规剂量。每4周为1周期,2周期后评价疗效。结果：全组患者均可评价疗效,其中完全缓解（CR）3例（9．4％）,部分缓解（PR）13例（40．6％）,稳定（SD）10例（31．3％）,进展（PD）6例（18．8％）,总有效率（ORR）为50．0％,TTP6．8个月,MOS14．6个月;Ⅲ-Ⅳ度毒副反应分别为血小板减少19．0％,白细胞减少14．0％,发热11．0％,恶心或呕吐9．0％。结论：以吉西他滨为主的联合化疗方案治疗晚期乳腺癌的近期疗效较好,生存时间有所延长,患者耐受性较好。     

恶性淋巴瘤的治疗研究

总结福建省肿瘤医院1209例恶性淋巴瘤（ML）治疗现状和研究进展,1209例ML中霍奇金病（HD）202型占16．7％,其总有效率为94．4％,Ⅰ至Ⅳ期5年生存率为79．4％,Ⅰ、Ⅱ期5年生存率为88．2％,其疗效与国内外相近,非霍奇金淋巴瘤（NHL）1007例,Ⅲ`Ⅳ期点66．9％,中、高度恶性占92．9％,用不同方案化疗。ProMACE-MOPP方案疗效较CHOP为高,对难治性,复发性MHL,老年NHL、小儿ML以及NHL的综合治疗也作了简单介绍。     

吉西他滨联合卡培他滨治疗复发转移性胃癌疗效分析

背景与目的：晚期复发转移性胃癌的治疗是临床治疗的一个难点,目前尚无二线治疗的标准方案。本研究通过吉西他滨联合卡培他滨方案,观察其对晚期进展期胃癌的近期疗效、不良反应和临床获益的情况。方法：30例晚期胃癌患者,全组均采用二线以上化疗方案。化疗方案为吉西他滨加卡培他滨。每例完成2个周期以上化疗（2～7个周期）,共114个周期。结果：30例患者客观有效率（RR）为20%,疾病控制率（DCR）为80%,进展（PD）占26.7%;中位缓解期4.5个月,中位生存期10.9个月。不良反应主要为骨髓抑制,Ⅲ～Ⅳ度白细胞减少者占33.3%。Ⅲ～Ⅳ度血小板减少者占30.1%,Ⅲ～Ⅳ度手足综合征占8.8%。无一例患者因不良反应而使治疗延期。结论：吉西他滨联合卡培他滨化疗方案二线治疗胃癌有一定疗效,不良反应可耐受,疾病控制率高,对多程化疗失败的晚期胃癌患者不失为一种安全的选择,多数患者可以通过化疗获益。     

脑胶质瘤术后三维适形放射治疗的疗效分析

目的探讨脑胶质瘤术后三维适形放射治疗的临床疗效。方法69例脑胶质瘤患者（WHOⅠ级2例,Ⅱ级18例,Ⅲ级18例,Ⅳ级31例）术后接受三维适形放射治疗,治疗剂量50～60Gy／25～30次,5撕周。35例未行化疗;34例同期或放疗后接受化疗（4娟周期）,其中18例口服替莫唑胺,16例为其他方案化疗。中位随访期13个月（6～31个月）。结果69例患者中,WHOⅠ级患者生存率100％,Ⅱ级94-4％,Ⅲ级61．1％,Ⅳ级41．9％。Ⅰ、Ⅱ级和Ⅲ、Ⅳ级肿瘤无进展的中位生存期分别为14．5个月和9．0个月（P=O．037）,中位生存期分别为14．5个月和13．0个月（P=0．131）,1年生存率分别为60．0％和49．0％。手术与放疗间隔时间≤4周的患者和〉4周的患者中位生存期分别为11．5个月和15．5个月（P=0.24）,1年生存率分别为47．7％和68.0％。34例化疗和35例非化疗患者中位生存期分别为13个月和13．5个月（P=0.532）,1年生存率分别为52．9％和51．4％。其中34例化疗患者中,口服替莫唑胺患者与其他方案化疗患者比较,中位生存期分别为11．5个月和15．5个月（P=0．187）,1年生存率分别为44．4％和62．5％。结论三维适形放射治疗对脑胶质瘤术后患者有较高的肿瘤局部控制率,     

Prospective randomized study comparing MEMID with a chop-like regimen in elderly patients with aggressive non-Hodgkin's lymphoma

OBJECTIVE: This multicenter phase III study compared the MEMID regimen (mitoxantrone, VP16, methylglyoxal, ifosfamide and dexamethasone) with CEOP, a CHOP-like regimen (cyclophosphamide, epirubicin, vincristine and prednisone), in elderly patients (> or =65 years) with aggressive non-Hodgkin's lymphoma (NHL). Methods: One hundred and forty-nine patients were eligible, 72 in the MEMID arm and 77 in the CEOP arm. The primary endpoint was to compare overall survival (OS) between groups, and secondary endpoints were event-free survival (EFS), response rate and toxicity. RESULTS: Neutropenia (p < 10(-5)), anemia (p < 10(-5)) and thrombocytopenia (p = 0.0006) were significantly more frequent in patients who received MEMID. We observed an objective response rate of 55.5% in the MEMID arm and 64.9% in the CEOP arm (p = 0.24). The median OS and EFS were 15.4 and 8.5 months in the MEMID arm, and 20.3 and 10.5 months in the CEOP arm (p = 0.59 and 0.47), respectively. The median EFS was 15.4 months in the MEMID arm and 20.3 months in the CEOP arm (p = 0.59). CONCLUSION: The increased toxicity without survival benefit confirms the superiority of CHOP and CHOP-like regimens for elderly patient with aggressive NHL.     

CTVP方案治疗侵袭性B细胞非霍奇金淋巴瘤85例临床疗效分析

评估含吡喃阿霉素（THP）及长春地辛（VDS）的CTVP方案治疗非霍奇金淋巴瘤（NHL）的近期疗效、远期生存及不良反应。方法:收集2000年1月至2005年12月间应用CTVP方案治疗的资料完整的侵袭性B细胞NHL患者85例,分析其近期疗效、远期生存及不良反应。结果:85例患者中初治74例,复治11例,全部病例均可评价疗效,一线治疗CR 55.4%,有效率68.9%,临床受益率86.0%,二线治疗有效率45.5%,临床受益率63.6%。随访至2009年12月,中位随访时间为69个月（6～102个月）,1、3、5年生存率分别为82.4%、71.5%和60.7%,中位生存期75个月（6～99个月）,骨髓抑制、胃肠道反应、乏力、外周神经毒性和脱发为主要不良反应。结论:采用含THP和VDS的CTVP方案治疗NHL疗效较好,毒性较低,远期生存率较高,值得临床进一步研究。      

DICE方案治疗复发或耐药中高度恶性非霍奇金淋巴瘤

背景与目的:复发或耐药非霍奇金淋巴瘤(non鄄Hodgkin蒺slymphoma,NHL)目前尚无标准的解救化疗方案,DICE、ESHAP、MINE和EPOCH等常见的解救治疗方案缓解率仅为30%～70%。本文旨在观察DICE方案作为解救化疗方案治疗复发或耐药中高度恶性NHL的疗效和安全性。方法:选取35例复发或耐药的中高度恶性NHL患者,其中T细胞和B细胞NHL分别为14和21例,既往接受过以CHOP或CHOP样方案为主中位6周期(2～12个周期)的化疗,采用DICE方案进行解救治疗。结果:35例患者接受了中位4周期(2～7个周期)的DICE方案化疗,所有患者均可评价疗效和不良反应。总的客观有效率为74.3%,完全缓解率为31.4%;中位缓解时间为4个月(1～30个月),中位至治疗失败时间为7个月(2～34个月),中位生存期为14个月(3～51个月),实际2年生存率为33.3%。T细胞和B细胞NHL的有效率分别为85.7%(12/14)和66.7%(14/21),完全缓解率分别为50.0%(7/14)和19.0%(4/21)(P=0.073)。LDH升高和伴有巨大肿块是影响解救治疗疗效的高危因素(P<0.05),DICE解救疗效是复发耐药患者生存期的独立预后因素(P=0.001)。主要不良反应为骨髓抑制,Ⅲ～Ⅳ度粒细胞和血小板减少的发生率分别为71.4%和8.6%。结论:DICE方案是复发或耐药中高度恶性NHL安全有效的解救治疗方案。LDH升高和伴有巨大     

Treatment of aggressive non-Hodgkin's lymphoma with dose-intensified epirubicin in combination of cyclophosphamide, vincristine, and prednisone (CEOP-100): a phase II study.

Epirubicin is an agent with a lower incidence of cardiotoxicity and myelotoxicity compared with doxorubicin; and it is active in patients with non-Hodgkin's lymphoma (NHL). Our aim was to define the therapeutic efficacy and toxicity of dose-intensified epirubicin in combination with cyclophosphamide, vincristine, and prednisone (CEOP) in patients with diffuse large-cell NHL. Previously untreated patients aged between 15 and 75 years, with at least one measurable lesion, adequate liver, renal, cardiac functions, and no central nervous system involvement were included in the study. The planned chemotherapy regimen CEOP consisted of cyclophosphamide 750 mg/m2, epirubicin 100 mg/m2, and vincristine 1.4 mg/m2 intravenously on day 1 and 100 mg prednisone taken orally on days 1 to 5. Courses were repeated every 21 days. Patients with stage I and II received four cycles of chemotherapy followed by involved-field radiotherapy, and patients with stage III and IV received six cycles of chemotherapy followed by radiotherapy to bulky lymph node sites. Seventy-five patients were enrolled in the study. The complete response rate was 83.8%, and 72 patients were assessable for toxicity. The most common toxicity was myelosuppression; 13.9% of the patients had grade III-IV neutropenia. Severe mucositis, diarrhea, and emesis were uncommon (<10%). At a median follow-up period of 41 months, the 5-year progression-free survival and overall survival rates were 63.5% and 65.3%, respectively. Increasing the dose intensity of epirubicin can yield a similar complete response rate compared with the regimens used in NHL without significantly increasing the toxicity rate associated with chemotherapy. The role of dose-intensive epirubicin should be investigated further in future randomized trials.     

MACOP-B Regimen Followed by Involved-Field Radiation Therapy in Early-Stage Aggressive Non-Hodgkin's Lymphoma Patients: 14-Year Update Results

A single-center, retrospective study was conducted to evaluate therapeutic results of the MACOP-B third-generation chemotherapy regimen followed by involved-field radiation therapy in a stage I-II aggressive non-Hodgkin's lymphoma (NHL) patients. From 1986 to 1995, 118 consecutive patients with the diagnosis of aggressive NHL, stage I-IE or II-IIE, with or without bulky disease were treated with MACOP-B regimen followed, when appropriate, by 30-36 Gy involved-field radiation therapy The complete response (CR) rate was 95% after the combined modality treatment (97% for stage I-IE and 93% for stage II-IIE). Patients with bulky disease had a CR rate of 92%. Treatment was well tolerated and no deaths occurred from acute toxicity. After a median follow-up of 68 months, 24 (21%) patients relapsed. The 14-year projected relapse-free and overall survival rates were 78% and d 69%, respectively. MACOP-B regimen with/without involved-field radiation therapy provides a safe and effective combined modality treatment for early-stage aggressive NHL, with the possibility to definitively cure two thirds of the patients     

MINE方案治疗复发或耐药的侵袭性淋巴瘤临床观察

背景与目的:复发或耐药侵袭性非霍奇金淋巴瘤(non-HodgkinQslymphoma,NHL)的治疗是当前恶性淋巴瘤治疗的难题,目前尚无标准的挽救性治疗方案。本研究目的是观察MINE方案(Mesna、IFO、Novantrone、VP-16)治疗复发或耐药侵袭性NHL的疗效和不良反应。方法:回顾性分析2001年1月至2003年6月收治的38例复发或耐药侵袭性NHL患者的临床资料,所有患者均接受过至少1个化疗方案的治疗,中位方案数为2个(1～4个),中位疗程数6个(2～12个)。采用MINE方案化疗2～6个疗程(中位疗程数4个)。结果:38例患者均可评价疗效和不良反应,总有效率47.4%,完全缓解率15.8%。B细胞来源淋巴瘤(26例)有效率57.7%,T细胞来源淋巴瘤(12例)有效率25.0%。全组1年生存率34.2%,2年生存率7.9%。主要不良反应为骨髓抑制,其中Ⅲ～Ⅳ度白细胞减少发生率为39.5%(15例),Ⅲ～Ⅳ度血小板减少发生率为13.2%(5例);1例患者出现Ⅲ度肝功能损害。结论:MINE方案为复发或耐药侵袭性NHL的经济、有效挽救治疗方案,不良反应可以耐受,但缓解时间较短,值得进一步研究应用。     

Alternation of epirubicin and mitoxantrone in CHOP-like regimens retains efficacy and reduces overall toxicity in elderly patients with high and intermediate grade non-Hodgkin lymphomas

Mitoxantrone and Epirubicin are active agents in non-Hodgkin's lymphomas (NHL). These drugs have reduced cardiotoxicity and therefore are indicated in treatment of elderly patients. Cyclophosphamide, mitoxantrone, vincristine and methylprednisone (CNOP) and cyclophosphamide, epirubicin, vincristine and methylprednisone (CEOP) are combination chemotherapy and contain Mitoxantrone and Epirubicin that have been shown to be effective in treatment of NHL of intermediate and highgrade of malignancy in the elderly. Since Mitoxantrone and Epirubicin are partially non-cross resistant their combined use may diminish emergence of resistant neoplastic clones and may be associated with enhanced anti-neoplastic activity. In this study, a polychemotherapy schedule alternating 3 cycles of CEOP and 3 cycles of CNOP, was used in a single center between December 1988 and April 1995 to treat 41 previously untreated patients, over 60 years of age affected by intermediate or high grade non-Hodgkin's lymphoma according to the Working Formulation. In treated patients, 57.5% achieved complete response, 35% partial response and 7.5% were non-responders. Overall survival was 52.4 % at 4 years, Disease free survival (DFS) for complete responders was 48.9%. Only one case of severe extrahematological toxicity (grade 3-4 WHO) was observed. Severe mucositis (grade 3-4 WHO) was absent, and delayed administration of chemotherapy was required in only 7/230 cycles. No treatment related deaths were registered. This regimen achieved results comparable to that of other anthracycline or mitoxantrone based chemotherapy, but determined lower toxicity. Alternating CEOP and CNOP may improve overall toxicity.     

CEOP regimen in the treatment of advanced low-grade non-Hodgkin's lymphomas: preliminary report

Between March 1987 and December 1988, 30 previously untreated patients with low-grade non-Hodgkin's lymphomas (NHL), according to the Kiel classification, were treated by a combination of therapy including cyclophosphamide, epirubicin, vincristine, and prednisone (CEOP). Eighteen patients (60%) achieved a complete pathologic remission, and 8 patients (26.6%) had a partial response with a reduction of more than 50% of tumor-related manifestations. Four patients (13.4%) were primary resistant to CEOP. The overall survival was 96.6% with a median follow-up of 25 months from the diagnosis; none of the patients who achieved complete response relapsed at a median follow-up of 21 months from the completion of treatment. Clinical and hematologic toxicities were irrelevant. This regimen was effective in inducing a good remission rate of low-grade NHL, but a longer follow-up for definitive conclusions is warranted.     

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。