GDP方案联合放疗治疗难治性NHL疗效及毒性分析

目的观察GDP方案联合放疗治疗难治性非霍奇金淋巴瘤（NHL）疗效及毒性反应。方法CHOP方案化疗3周期未获完全缓解的NHL患者43例，随机分成GDP方案治疗组和GDP方案联合放疗组。观察两组的肿瘤有效率、白细胞和血小板抑制率、治疗后白细胞和血小板的恢复时间。结果化疗组和化疗联合放疗组总有效率分别为22．7％、66．7％，差异有极显著性（x2=8．41，P〈0．01）；3度以上白细胞抑制率分别为22．7％、52．4％，差异有显著性（x2=4．04，P〈0．05）；3度以上血小板抑制率分别为31．8％、42．9％，差异无显著性（x2=0．56，P〉0．05）；C—CSF治疗后白细胞恢复时间分别为（3．6±1．5）天、（5．7±2．3）天，差异有极显著性（x2=3．563，P〈0．01）；IL—11治疗后血小板恢复时间分别为（6．5±2．6）天、（12．3±4．1）天，差异有极显著性（t=-5．567，P〈0．01）。结论GDP方案联合放疗可提高难治性NHL的肿瘤有效率，但3度以上白细胞抑制率增加、白细胞和血小板的恢复时间延长。

The efficacy and toxicities of GDP protocol combined with radiotherapy for refractory Non-hodgkin's lymphoma

Objective To investigate the efficacy and toxicities of GDP protocol combined with radiotherapy for refractory Non-hodgkin's lymphoma ( NHL ).Methods 43 patients with NHL who had received CHOP protocol for three cycles but not achieved complete response were randomly assigned to group with GDP alone or group with GDP plus radiotherapy.The response rate,rates of platelet and leukocyte inhibition,and recovery time to platelet and leukocyte after treatment were observed.Results Tthe overall response rate (PR+CR) was 22.7％ for the group with GDP alone and 66.7％ for the group with GDP plus radiotherapy ( x2=8.41,P＜ 0.01 ); leukocyte inhibition rate of grade Ⅲ or above was 22.7％ and 52.4％,respectively ( x 2=4.04,P ＜ 0.05 ); platelet inhibition rate of grades Ⅲ or above was 31.8％ and 42.8％ ( x2=0.56,P＞ 0.05 ); recovery time to platelet after therapy with C-CSF was ( 3.6 ± 1.5 ) days and ( 5.7 ± 2.3 ) days,respectively ( t=3.563,P＜ 0.01 ); and recovery time to platelet after treatment with IL-11 was ( 6.5 ± 2.6 ) days and ( 12.3 ± 4.1 ) days ( t =5.567,P ＜ 0.01 ).Conclusions GDP protocol combined with radiotherapy can enhance the overall response rate in patients with refractory Non-hodgkin's lymphoma.However,leukocyte inhibition rate of grade Ⅲ or above increases and recovery time to platelet and leukocyte prolongs.