GDP方案治疗复发或难治性非霍奇金淋巴瘤的效果观察

目的 探讨吉西他滨联合顺铂和地塞米松（GDP）方案治疗复发或难治性非霍奇金淋巴瘤（NHL）的效果和不良反应.方法 回顾性分析新疆医科大学附属肿瘤医院2008年6月～2010年6月收治的37例复发或难治性NHL患者的临床资料,其中复发者24例,难治者13例.所有患者采用GDP方案治疗,第1、8天给予吉西他滨1000 mg/m2,第1～3天给予顺铂25 mg/m2,第1～4天给予地塞米松40 mg联合化疗,每21天为1个化疗周期.2～6个化疗周期后观察其疗效及不良反应情况.结果 经过2～6个化疗周期后,37例患者中总有效率为54.1％（20/37）,完全缓解率为18.9％ （7/37）,复发性病例有效率为60.9％,难治性病例有效率为42.9％,两组有效率比较差异无统计学意义（P＞0.05）.化疗后不良反应主要是骨髓抑制（Ⅲ～Ⅳ度中性粒细胞减少的发生率为21.6％,血小板减少的发生率为29.7％）和消化道反应（Ⅲ～Ⅳ度恶心呕吐的发生率24.3％）,脱发、肝功能损伤及末梢神经炎不良反应轻,对症治疗后均有缓解.结论 GDP方案对部分复发或难治性NHL的解救有一定疗效,适宜临床应用.

Observation on efficacy of GDP regimen on relapsed or refractory non-Hodgkin lymphoma

Objective To explore the effect and adverse reactions on the therapy of relapsed or refractory non-Hodgkin lymphoma （NHL） by Gemcitabine plus Cisplatin and Dexamethasone （GDP）.Methods A retrospective analysis was made on 37 cases of patients with relapsed or refractory NHL in the Tumor Hospital Affiliated to Xinjiang Medical University from June 2008 to June 2010.It included 24 cases of relapsed patients and 13 cases of refractory patients.All patients used GDP treatment,they received Gemcitabine 1000 mg/m2 in the first day and eighth day; injected Cisplatin chemotherapy 25 mg/m2 in the first day to the third day,used Dexamethasone 40 mg in the first day to the fourth day,every 21 days as a cycle.The curative effect and adverse reactions were observed after 2-6 cycles of chemotherapy.Results By 2-6 cycles of chemotherapy,the total effective rate was 54.1％ （20/37）,the CR rate was 18.9％ （7/37）,relapsed cases effective rate was 60.9％,refractory cases effective rate was 42.9％,there were no significant differences in efficiency between both groups （P ＞ 0.05）.The main adverse reactions after chemotherapy were bone marrow suppression （the incidence of stage Ⅲ-Ⅳ of neutropenia was 21.6％,the incidence of stage Ⅱ-Ⅳ of thrombocytopenia was 29.7％） and gastrointestinal reactions （the incidence of stage Ⅲ-Ⅳ of nausea and vomiting was 24.3％）,the adverse reactions of alopecia,hepatic dysfunction,peripheral neuritis were mild and then were all relieved after symptomatic treatment.Conclusion GDP regimen has a certain effect on relapsed or refractory NHL,so it＇s a perfect selection for clinic.