硼替佐米联合阿霉素、地塞米松治疗初治多发性骨髓瘤的疗效观察

目的　比较硼替佐米联合阿霉素、地塞米松方案（ＰＡＤ方案）与长春新碱联合阿霉素、地塞米松方案（ＶＡＤ方案）治疗初治多发性骨髓瘤（ＭＭ）的疗效和不良反应。方法　ＰＡＤ方案组４１例患者给予硼替佐米１.３ｍｇ／ｍ２静推，第１、４、８、１１天；阿霉素１０ｍｇ／ｄ静滴，第１～４天；地塞米松２０ｍｇ／ｄ静滴，第１～４天，３周为１个周期，每例接受２～６个周期化疗。４０例ＶＡＤ方案组患者予长春新碱０.５ｍｇ／ｄ静滴，第１～４天；阿霉素１０ｍｇ／ｄ静滴，第１～４天；地塞米松２０ｍｇ／ｄ静滴，第１～４天，４周为１个周期，每例接受２～８个周期化疗。化疗２个周期后评价两组患者的疗效和不良反应。结果　两组患者均可评价疗效和不良反应。化疗２个周期后，ＰＡＤ方案组获显效２２例（５３.７％），ＶＡＤ方案组获显效１０例（２５.０％），差异有统计学意义（Ｐ＜０.００１）。两组主要不良反应包括消化道症状、周围神经炎、血小板减少、白细胞减少和感染，多为１～２级，经对症治疗后均可缓解。结论 ＰＡＤ方案治疗初治ＭＭ的显效率明显高于ＶＡＤ方案，不良反应可耐受。

Efficacy evaluation of bortezomib combined with adriamycin and dexamethasone for initial treatment of multiple myeloma

Objective To evaluate the efficacy and side effects between PAD regimen and VAD regimen for initial treatment of multiple myeloma(MM) patients. Methods Forty-one MM patients were treated with PAD regimen and each patient received 2-6 cycles of chemotherapy(bortezomib 1.3mg/m2 ivp,d1,d4,d8,d11;adriamycin 10mg/d iv,d1-d4;dexamethasone 20mg/d iv,d1-d4;3 weeks was a cycle),while 40 patients received VAD regimen(vincristine 0.5mg/d iv,d1-d4;adriamycin 10mg/d iv,d1-d4;dexamethasone 20mg/d iv,d1-d4;3 weeks was a c...