复发耐药性非霍奇金淋巴瘤小鼠肾包膜下移植肿瘤药敏测定的临床意义

目的:探讨小鼠肾包膜下移植肿瘤药敏测定(SRCA)在复发耐药NHL治疗中的作用.方法:对25例CHOP方案化疗后出现复发耐药的NHL病人进行了SRCA药敏测定,并依据SRCA结果进行化疗.结果:NHL肿瘤细胞在小鼠肾包膜下能够快速生长,移植成功率100%;复发耐药NHL对CTX、VCR、ADM表现为耐药,而对VP_(16)、MTX、DDP敏感性较高,其中对VP_(16)的敏感性显著高于CTX和VCR(P<0.05);依据药敏结果化疗,25例病人6例CR、13例PR,总有效率76%;其中21例接受由VP_(16)、MTX、DDP和强的松组成的方案治疗,6例CR,11例PR,有效率达81%.结论:NHL适宜用SRCA法进行药敏测定;复发耐药NHL的治疗可以VP_(16)、MTX和DDP为基础;化疗前进行SRCA药敏测定,能够减少用药盲目性,提高有效率.

Clinical value of mouse subrenal capsule assay in refractory non-Hodgkin''s lymphoma

Purpose:To investigate the clinical value of mouse subrenal capsule assay (SRCA) in refractory non-Hodgkin's lymphoma(NHL) . Methods: 25 NHL patients who were relapsed or drug-resisted after CHOP regimen treatment were underwent SRCA, and their following chemotherapy was based on the SRCA outcome. Results:The NHL cell grew rapidly un-der mice renal capsule within 5 days and the evaluability rate was 100% , the anticancer activity of 6 common used drug from high to low was in the order of VP_(16)?MTX?DDP?ADM? VCR and CTX, VP_(16) had a significantly higher anticancer activity than CTX and VCR (Ridit test,P<0. 05) ; In 25 patients treated according to SRCA outcome, 6 cases achieved CR, 13 PR, the overall ob-jective response rate was 76% ; In 21 patients treated with regimen comtaining VP_(16) MTX?DDP and Pred as indicated by SRCA, 6 achieved CR and 11 PR, the objective response rate was 81%. Conclusions: The refractory NHL is suitable to SRCA for drug sensitirity assay and its treatment regimen should base on VP_(16)?MTX and DDP; It could avoid blindness in the treatment to make SRCA before chemotherapy.