美罗华联合CHOP方案治疗弥漫性大B细胞淋巴瘤的疗效观察

摘要

Objective To evaluate the efficacy and toxicity of rituximab plus CHOP in patients with diffuse large B-cell lymphoma. Methods A total of 48 patients with histopathologically confirmed CD20-positive diffuse large B-cell lymphoma were randomly as-signed into two groups:24 received CHOP plus rituximab(R-CHOP group),and 24 received CHOP alone(CHOP group).All patients received six chemotherapy cycles,and the therapeutic effect was assessed. Results The overall response rate was 91.7%(22/24)in the R-CHOP group and 66.7%(16/24)in the CHOP group(P<0.05).The 1-and 3-year survival rates were 95.8% and 83.3%in the R-CHOP group,and 74.7% and 50.0% in the CHOP group.The 1-and 3-year progression-free rates were significantly higher in the R-CHOP group(82.6% and 62.8%)than in the CHOP group(57.3% and 37.2%,P<0.05).The major side effects in the two groups were myelosuppression,gastrointestinal toxicity and infusion-related adverse reactions.The two groups did not differ significantly in adverse reactions,except chills and fever. Conclusion Combination chemotherapy including Rituximab and CHOP (R-CHOP)is effective and well-tolerated by patients,suggesting it is a good treatment for diffuse large B-cell lymphoma.%　　目的观察美罗华联合CHOP方案治疗弥漫性大B细胞淋巴瘤的疗效及不良反应。方法48例CD20阳性的弥漫性大B细胞淋巴瘤患者，随机分为观察组和对照组，每组24例。观察组采用美罗华联合CHOP方案化疗，对照组单用CHOP方案化疗。全部患者完成6个周期化疗后评价疗效。结果观察组和对照组的总有效率分别为91.7%（22/24）和66.7%（16/24），1年总生存率（OS）分别为95.8%和74.7%，3年OS分别为83.3%和50.0%，1年无进展生存率（PFS）分别为82.6%和57.3%，3年PFS分别为62.8%和37.2%，以上两组比较差异均有统计学意义（P<0.05）。两组患者的不良反应主要为胃肠道反应、骨髓抑制和输液相关不良反应。除畏寒、发热外，其余不良反应的发生率差异均无统计学意义（P跃0.05）。结论美罗华联合CHOP方案治疗弥漫性大B细胞淋巴瘤疗效较好，未增加化疗毒性，安全性好，值得临床推广应用。