GDP和DICE方案治疗老年晚期复发难治性弥漫大B细胞淋巴瘤的临床研究

目的：比较GDP与DICE两种二线方案治疗老年晚期复发难治性弥漫大B细胞淋巴瘤的疗效和不良反应。方法：将42例老年晚期复发难治性弥漫大B细胞淋巴瘤患者随机分为GDP组（20例）和DICE组（22例）。观察近期疗效、毒副反应和生存情况。结果：GDP组和DICE组1年无事件生存率分别为85％和63．6％，无进展生存分别为35％和22．7％；CR分别为35％和18．2％，PR分别为40％和22．7％，SD分别为15％和27．3％，PD分别为10％和36．4％，疾病缓解率分别为75％和40．9％，差异显著。两组末梢神经炎发生率分别为2．5％和8．4％；脱发发生率分别为2．5％和7．5％；胃炎发生率分别为2．5％和10．9％，差别显著（P〈0．05），血液学毒性发生率分别为20．7％和18．5％（P〉0．05），无显著差别，但GDP组血栓形成明显大于DICE组，差别显著。结论：在治疗老年晚期复发难治性弥漫大B细胞淋巴瘤中GDP方案优于DICE方案，毒副反应较轻，但血液学毒性中血栓形成明显高于DICE组。

Clinical study of GDP and DICE regimens in the treatment of recurrent or refractory old patients with late staged DLBCL

Objective ： To evaluate the response and side effects of GDP and DICE regiments in the treatment of re-current or refractory late staged DLBCL old patients, nethods：A total of 42 DLBCL old patients with recurrent or re-fractory in late staged were randomized into two groups：GDP group （20 patiens） and DICE group （22 patiens）. The toxicity and survival time of the two groups were compared. Results ： In group GDP and DICE, the complete remission ratio were 35% and 18.2% ,partial response tatio 40% and 22.7% ,the stable disease 15% and 27.3% ;the pro- gressive disease 10% and 36.4% ,the disease remission ratio 75% and 40.9% ,the one - years no - event survival rate 85% and 63.6% ,the one - year no - progression survival rate 35% and 22.7% （P 〈 0.05 ） . The peripheral neuritis in GDP group （ 2. 5 % ） was lower than that in DICE group （8.4%） （P 〈 0.05）. Gastritis （2.5% vs 10.9 % ） and baldness （2.5 % vs 7.5 % ） in GDP group was lower than that in DICE group significantly （P 〈 0.05 ）. Hematologic toxity was no predominance in two groups （20.7% vs 18.5% , P 〉 0.05 ）, but in GDP group thrombosis rheighter than DICE group （P 〈 0.05 ）. Conclusion：The effect of GDP regimen is better than DICE in the treatment of recurrent or refractory late staged DLBCL old patients. But peripheral neuritis, gastritis and baldness in GDP regimen are lower than those in DICE regimen. Total ematologic toxity was no diffecence in two groups, but in GDP group Ⅲ-Ⅳ grade thrombosis is highter than DICE group. GDP regimen may be the first line chemotherapy regimen in the treat-ment of recurrent or refractory late staged DLBCL in old patients.