B-CHOP与CHOP方案对老年复发性套细胞淋巴瘤患者的疗效比较

目的 对比硼替佐米联合CHOP（B-CHOP）方案和CHOP方案对老年复发性套细胞淋巴瘤患者的疗效。方法 收集2009年1月至2015年1月老年复发性套细胞淋巴瘤患者38例，随机分为试验组（B-CHOP方案）和对照组（CHOP方案），每组各19例。试验组采用B-CHOP方案治疗：硼替佐米1.6 mg／m2静推，第1、8天；环磷酰胺750 mg／m2静滴，第2天；阿霉素50 mg／m2静滴，第2天；长春新碱 1.4 mg／m2（最大剂量为2 mg）静滴，第2天；强的松100 mg／天口服，第2～6天。对照组采用CHOP方案：环磷酰胺750 mg／m2静滴，第1天；阿霉素50 mg／m2静滴，第1天；长春新碱 1.4 mg／m2（最大剂量为2 mg）静滴，第1天；强的松100 mg／天口服，第1～5天。两组均以28天为1周期，共化疗8个周期。分别于第4、8个周期化疗完成后采用非霍奇金淋巴瘤国际疗效判断标准进行评价，根据随访资料分析远期生存情况。结果 试验组化疗4个周期后获完全缓解（CR）10例、部分缓解（PR）4例、无反应（NR）3例、进展（PD）2例，8个周期后获CR 12例、PR 4例、NR 1例、PD 2例；对照组化疗4个周期后获CR 3例、PR 2例、NR 10例、PD 4例，8个周期后获CR 5例、PR 3例、NR 7例、PD 4例。试验组第4、8个周期化疗完成后的有效率（RR）为73.7％和84.2％，均高于对照组的26.3％和42.1％，差异有统计学有意义（P＜0.05）。试验组的中位总生存时间为56.0个月，高于对照组的29.0个月（P＜0.05）。两组主要不良反应为发热、白细胞减少、血小板减少和周围神经炎等，且两组不良反应发生率的差异无统计学意义（P＞0.05）。结论 在改善老年复发性套细胞淋巴瘤患者的RR和OS方面，B-CHOP方案明显优于CHOP方案。

Curative effect comparison of B-CHOP and CHOP regimens on elderly patients with recurrent mantle cell lymphoma

Objective To explore the curative effect of bortezomib-CHOP ( B-CHOP ) regimen versus CHOP regimen on eld-erly patients with recurrent mantle cell lymphoma. Methods Thirty-eight elderly patients with recurrent mantle cell lymphoma from Jan 2009 to Jan 2015 were enrolled in this study and randomly assigned to CHOP regimen ( control group, n=19) and B-CHOP regi-men ( experimental group, n=19) . B-CHOP regimen:bortezomib 1. 6 mg/m2 iv bolus d1 , d8; cyclophosphamide 750 mg/m2 iv d2;doxorubicin 50 mg/m2 iv d2;vincristine 1. 4 mg/m2( max dose 2 mg/m2 ) iv d2;prednisone 100 mg/d po d2-d6 . CHOP regimen:cy-clophosphamide 750 mg/m2 iv d1;doxorubicin 50 mg/m2 iv d1; vincristine 1. 4 mg/m2( max dose 2 mg/m2 ) iv d1; prednisone 100 mg/d po d1-d5 . All the patients underwent 8 cycles of chemotherapy with 28 days as a cycle. The efficacy evaluation was carried out at the 4th and 8th cycle according to the non-Hodgkin’s lymphoma international standard. The long-term survival was analyzed using the fol-low-up data. Results In experimental group, there were 10 cases of complete remission ( CR) , 4 cases of partial remission ( PR) , 3 cases of no response ( NR) and 2 cases of progression ( PD) after 4 cycles, and 12 cases of CR, 4 cases of PR, 1 case of NR and 2 cases of PD after 8 cycles. In control group, there were 3 cases of CR, 2 cases of PR, 10 cases of NR and 4 cases of PD after 4 cycles, and 5 cases of CR, 3 cases of PR, 7 case of NR and 4 cases of PD after 8 cycles. In experimental group, the response rate ( RR) of 4th and 8th cycles were 73. 7% and 84. 2%, which were higher than 26. 3% and 42. 1% of control group ( P<0. 05) . The median overall survival in experimental group was 56. 0 months, longer than 29. 0 months in control group ( P<0. 05) . The main side effects of the two groups were fever, leukopenia, thrombocytopenia, and peripheral neuritis, and etc. The incidence of side effects between the two groups had no difference( P>0. 05) . Conclusion B-CHOP regimen shows better RR and overall survival than CHOP regimen in elder-ly patients with recurrent mantle cell lymphoma.