盐酸帕洛司琼联合GDP方案治疗老年复发性非霍奇金淋巴瘤的临床研究

目的评价盐酸帕洛司琼联合GDP (Palonosetron-GDP) 方案治疗老年复发性非霍奇金淋巴瘤的临床疗效和不良反应。方法采用Palonosetron-GDP方案治疗28例老年复发性非霍奇金淋巴瘤患者，对接受3个疗程以上患者进行临床疗效评估和不良反应分析，同时随访患者疾病进展情况。结果26例患者接受3个疗程以上Palonosetron-GDP方案化疗，其中6例完全缓解 (完全缓解率23.1%)，10例部分缓解(部分缓解率38.5%)，总有效率61.5%。26例患者中位肿瘤进展时间为5.3月(95%CI: 4.7~7.0)。主要不良反应为骨髓抑制，而非血液学毒性尤其是消化道不良反应轻微，其中化疗诱导恶心和呕吐不良反应Ⅰ级2例，Ⅱ级1例，没有Ⅲ~Ⅳ级呕吐反应。结论Palonosetron-GDP方案是老年复发性非霍奇金淋巴瘤的有效挽救治疗方案，其中盐酸帕洛司琼能有效预防化疗诱导的消化道不良反应而不影响其疗效。

Clinical Study on Palonosetron Combined with GDP Regimen in Treatment of Elderly Patients with Relapsed Non-Hodgkin's Lymphoma

ObjectiveTo evaluate the clinical efficacy and toxicity of palonosetron combined with GDP (Palonosetron-GDP)regimen in the treatment of elderly patients with relapsed non-Hodgkin's lymphoma.MethodsA total of 28 elderly patients(age ≥ 60 years) with relapsed non-Hodgkin’s lymphoma were enrolledin this pilot study. Responses and toxicities were evaluated for patients who received at least three courses of chemotherapy. Meanwhile, time to progression (TTP) was measured.ResultsFrom January 2009 to January 2012, 26 elderly patients with relapsed non-Hodgkin's lymphoma receivedat least three cycles of Palonosetron-GDP therapy and were evaluable for response analysis. Sixpatients achieved complete remission, while ten cases obtainedpartial response. The overall responserate was 61.5%. The median time to progression (TTP) was 5.3 months (95%CI: 4.7-7.0 months). Major toxicity ofthis regimen was myelosuppression, while other non-hematologic toxicities, especially gastrointestinal adverse effects were moderate in all the patients. Concerning chemotherapy induced nausea and vomiting (CINV),no grade Ⅲ–Ⅳ CINV occurred, although grade Ⅰ and Ⅱ CINV wereobserved in two and one patients, respectively.ConclusionPalonosetron-GDPwas an effective salvage therapeutic regimen for elderly patients with relapsed non -Hodgkin's lymphoma. Meanwhile, palonosetron might stro ngly preventfromchemotherapy-associated gastrointestinal