培门冬酶联合GEMOX方案治疗初治鼻腔NK/T细胞淋巴瘤临床疗效观察

  目的  观察培门冬酶联合GEMOX方案治疗初治鼻腔NK/T细胞淋巴瘤的临床疗效及安全性。   方法  分析2011年6月至2012年3月间天津医科大学肿瘤医院收治的初治鼻腔NK/T细胞淋巴瘤12例,采用P-GEMOX治疗,具体剂量为吉西他滨800~1 000 mg/m2,d1,8;奥沙利铂130 mg/m2,d1;培门冬酶2 500 IU/m2,d2,每21天为1个周期。评价疗效及不良反应。   结果  12例患者中1例出现急性胰腺炎退出治疗,余11例在接受P-GEMOX方案2个周期治疗后,完全缓解（CR）1例,部分缓解（PR）7例,疾病稳定（SD）2例,疾病进展（PD）1例,客观有效率（ORR）为72.7%,疾病控制率（DCR）为90.9%。全组患者2年总生存（OS）率达90.9%。11例患者接受中位6个周期的P-GEMOX方案化疗,不良反应发生率为81.8%,7例患者出现骨髓抑制（63.6%）,5例患者出现转氨酶升高（45.5%）,4例患者出现恶心呕吐（36.4%）,2例患者出现凝血因子异常（18.2%）,无一例患者出现严重过敏反应、血栓形成及血糖异常。   结论  培门冬酶联合GEMOX方案治疗初治鼻腔NK/T细胞淋巴瘤疗效好,但不良反应发生率较高。 

Clinical efficacy of pegaspargase plus GEMOX regimen for initial treatment of nasal NK/T-cell lymphoma

  Objective  To evaluate the efficacy and safety of pegaspargase plus GEMOX (pegaspargase, gemcitabine, oxaliplatin) regimen in the initial treatment of nasal NK/T-cell lymphoma.   Methods   Twelve preliminarily diagnosed nasal NK/T-cell lymphoma patients in Tianjin Medical University Cancer Institute and Hospital from June 2011 to March 2012 were analyzed. All patients took the pegaspargase plus GEMOX regimen (gemcitabine 800-1 000 mg/m2 on days 1 and 8, oxaliplatin 130 mg/m2 on day 1, and pegaspargase 2 500 IU/m2 on day 2), every three weeks for one cycle. The efficacy and toxicity of the regimen were evaluated in the follow-up treatment.   Results   After two cycle treatments, 1 patient dropped out of treatment because of acute pancreatitis; the remaining 11 patients had response, in which 1 achieved complete response, 7 had partial response, 2 had stable disease, and 1 had progressive disease. The objective response rate was 72.7%, and the disease control rate was 90.9%. The 2-year overall survival rate was 90.9%. With median 6-cycle P-GEMOX regimen treatment, 81.8% of 11 patients presented side effects, primarily myelosuppression and hepatic dysfunction.   Conclusion   Pegaspargase plus GEMOX regimen showed high efficacy on the initial treatment of nasal NK/T-cell lymphoma patients, but the incidence of adverse effect was still high.