以吉西他滨为基础的化疗方案治疗初治弥漫大B细胞淋巴瘤的临床观察

目的观察比较R-GDP方案和R-CHOP方案治疗初治弥漫大B细胞淋巴瘤的疗效、生存和毒副反应。方法 100例DLBCL患者随机分为R-GDP组和R-CHOP组,4个周期后评价疗效,并随访统计比较总生存期及无疾病进展生存期。结果 (1)近期疗效:R-GDP组总体缓解率91.66%;R-CHOP组总体缓解率86.54%。两组比较差异无统计学意义(P=0.413)。(2)远期疗效:R-GDP组平均OS为32.730个月,R-CHOP组平均OS为31.623个月,两组OS比较差异无统计学意义(P=0.394)。R-GDP组平均PFS为25.137个月,R-CHOP组平均PFS为25.202个月,两组PFS比较差异无统计学意义(P=0.951)。(3)毒副反应:R-CHOP组在脱发、心脏毒性、静脉炎发生率明显多于R-GDP组,两组比较差异有统计学意义(P<0.05)。结论 R-GDP方案与R-CHOP方案治疗初治DLBCL近期疗效与远期疗效均无明显差异,两者均可作为初治DLBCL的首选方案。R-GDP组不良反应轻,耐受性好。

Clinical observation of gemcitabine-based chemotherapy in the treatment of previously untreated diffuse large B-cell lymphoma

Objective To observe and compare the therapeutic efficacy,survival and toxicity between R-GDP regimen and R-CHOP for the treatment of newly diagnosed patients with diffuse large B cell lymphoma.Methods 100 cases with DLBCL were randomly divided into groups of the R-CHOP group and R-GDP group which were evaluated after four cycles,and follow-up statistical comparisons of overall survival and progression-free survival the period.Results A short-term effect of R-GDP group overall remission rate was 91.66% and the R-CHOP group the overall response rate was 86.54%.There was no significant difference (P=0.413).OS of the R-group average of GDP of long-term effect was 32.730 months.The average OS of R-CHOP group was 31.623 months.Two groups of OS have no significant difference (P=0.394).Median PFS of R-GDP group was 25.137 months and R-CHOP group was 25.202 months.PFS of two groups was no significant difference (P=0.951).The hair loss,cardiac toxicity and phlebitis incidence of R-CHOP group were significantly more than the R-GDP group (P < 0.05).Conclusion R-GDP program with R-CHOP regimen previously untreated DLBCL term efficacy and long-term efficacy have no significant difference.They can be used as the preferred solution of untreated DLBCL.R-GDP has light adverse reaction and good tolerance.