改良的CHOPE方案治疗EBV阳性恶性淋巴瘤的临床疗效观察

目的:观察改良的CHOPE方案（环磷酰胺+柔红霉素+长春新碱+泼尼松）治疗EBV阳性的恶性淋巴瘤的临床疗效及毒副反应。方法:本研究采用改良的CHOPE方案联合抗病毒及局部放射治疗，治疗了46例EBV阳性的恶性淋巴瘤。结果:3个疗程评估完全缓解(CR)21例(45.7%)，部分缓解(PR)12例(26.1%) ，8例为稳定状态(SD)，5例疾病进展（PD），总有效率为 71.7%。治疗结束后总有效率达81.2%，46例患者1 年总生存率(OS)为78% ，1年无病生存率(DFS)69%；3年OS为34.7%，3 年DFS为31%。结论:总体而言改良的CHOPE方案治疗EBV阳性淋巴瘤有效，毒副反应可安全耐受，但长期生存率仍然较差，因此对于EBV阳性的恶性淋巴瘤患者在强调早期强化疗的基础上应把异基因造血干细胞移植提上议程，以获得更好的治疗效果。

Modified CHOPE regimen on the outcome of malignant lymphoma with EBV infection

Objective:To observe the clinical efficacy and side effects of modified CHOPE regimen in the treatment of EBV positive malignant lymphoma.Methods:In this study,46 patients with EBV positive lymphoma were treated with modified CHOPE regimen combined with antiviral and local radiotherapy.Results:21 cases(complete remission rate 45.7%) achieved complete remission,12 cases(partial remission rate of 26.1%) achieved partial remission,stable state in 8 cases and 5 cases of disease progression,the total effective rate was 71.7%.After treatment,the total effective rate was 81.2%.The 1 year overall survival rate was 78%,the 1 year disease-free survival rate was 69%,the 3 years overall survival rate was 34.7%,and the 3 years disease-free survival rate was 31%.Conclusion:Modified regimen CHOPE is effective in the treatment of lymphoma with EBV positive.The side effects can be safe and well tolerated,but long-term survival is still poor.So allogeneic peripheral blood stem cell transplantation should be taken into consideriation in malignant lymphoma with EBV to obtain a long- term survival.