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ABVD第1、8天用药方案治疗初治霍奇金淋巴瘤疗效观察
引用本文:李玉富,张艳莉,房伯俊,杜建伟,吕晓东,张丽娜,朱兴虎,魏旭东,宋永平,李继昌. ABVD第1、8天用药方案治疗初治霍奇金淋巴瘤疗效观察[J]. 中华内科杂志, 2009, 48(3). DOI: 10.3760/cma.j.issn.0578-1426.2009.03.004
作者姓名:李玉富  张艳莉  房伯俊  杜建伟  吕晓东  张丽娜  朱兴虎  魏旭东  宋永平  李继昌
作者单位:1. 郑州大学第一附属医院消化内科,450052
2. 河南省肿瘤医院血液科
摘    要:目的 探讨阿霉素、博莱霉素、长春新碱、氮烯咪胺(ABVD)第1、8天用药方案治疗初治霍奇金淋巴瘤(HL)的疗效.方法 将我院2005年10月-2006年10月收治的Ⅱ~Ⅳ期初治HL62例患者,采用随机分组的方法将患者分为A、B两组,每组均为31例,A组采用ABVD第1、8天用药方案进行化疗6~8周期,B组采用ABVD第1、15天用药方案进行化疗6~8周期,两组患者化疗结束后均南同一位放疗科医生根据具体情况给予放疗,制定放疗方案不受A、B分组的影响.结果 A组化疗结束后完全缓解(CR)率90.3%(28/31),1年无病生存(DFS)率87.1%(27/31),2年DFS80.0%(20/25).B组化疗结束后CR 83.9%(26/31),1年DFS 80.6%(25/31),2年DFS 72.0%(18/25).A、B两组CR率、1年DFS率、2年DFS率比较,差异均无统计学意义(P>0.05).治疗相关的毒副反应,心肌缺血、Ⅲ~Ⅳ度肝功能损害、重度骨髓抑制等比较,差异无统计学意义(p>0.05).A组每例患者从化疗开始到化疗结束的平均时间为159 d,B组为228 d,A组较B组平均每人缩短69 d.结论 采用ABVD第1、8天用药方案治疗初治Ⅱ~Ⅳ期HL与第1、15天用药方案治疗CR率、1年DFS率、2年DFS率比较均相似,但A组有优于B组的趋势,治疗相关的毒副反应也相似,但在治疗时间上A组显著缩短.

关 键 词:霍奇金病  抗肿瘤联合化疗方案  无病生存

ABVD chemotherapy scheme at day 1 and 8 for treatment of primary Hodgkin's lymphomas
LI Yu-fu,ZHANG Yan-li,FANG Bo-jun,DU Jian-wei,LU Xiao-dong,ZHANG Li-na,ZHU Xing-hu,WEI Xu-dong,SONG Yong-ping,LI Ji-chang. ABVD chemotherapy scheme at day 1 and 8 for treatment of primary Hodgkin's lymphomas[J]. Chinese journal of internal medicine, 2009, 48(3). DOI: 10.3760/cma.j.issn.0578-1426.2009.03.004
Authors:LI Yu-fu  ZHANG Yan-li  FANG Bo-jun  DU Jian-wei  LU Xiao-dong  ZHANG Li-na  ZHU Xing-hu  WEI Xu-dong  SONG Yong-ping  LI Ji-chang
Abstract:Objective To explore the effect of adriamycin, bleomyein, vincristine and dacarbazinum (ABVD) chemotherapy scheme executed at day I and day 8 for primary Hodgkin's lymphomas (HL). Methods 62 patients with primary HL in stages Ⅱ-Ⅳ treated in our department from October 2005 to October 2006 were divided into group A and B at random with 31 patients in each group. The patients in group A received ABVD chemotherapy scheme executed at day 1 and day 8 for 6-8 cycles. The patients in group B received ABVD chemotherapy scheme executed at day 1 and day 15 for 6-8 cycles. The patients of the groups received radiotherapy by the same doctor after chemotherapy according to the patients condition and the radiotherapy regimens were not affected by the grouping. Results The complete remission rate (CR)in group A after chemotherapy was 90. 3% (28/31);the one-year and two-year disease free survival (DFS) rates were 87. 1% (27/31) and 80.0% (20/25)respectively. The CR rate in group B after chemotherapy was 83.9% (26/31);the one-year and two-year DFS rates were 80. 6% (25/31)and 72. 0% (18/25) respectively. The discrepancy of CR rates and the one-year and two-year DFS rates between the two groups was not significant (P>0.05). The incidences of therapeutic side effecte such as myocardial iscnemia grade Ⅲ-Ⅳ liver function impair-ment,pulmonary fibrosis and serious marrow inhibition between the two groups were not significant too (P > 0.05). Average chemotherapy period for the patients in group A was 159 days; it was 69 days shorter than that in group B. Conclusion The CR rate,1-year DFS rate and 2-year DFS rate of ABVD chemotherapy scheme executed at day 1 and 8 are similar to those of ABVD chemotherapy scheme executed at day Ⅰ and 15 for primary HL in stages Ⅱ-Ⅳ. The side-effects of chemoterapy between group A and B are similar too. The chemotherapy period in group A is shortened significantly.
Keywords:Hodgkin disease  Antineoplastic combined chemotherapy protocols  Disease-free survival
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