VD方案和VAD方案治疗多发性骨髓瘤的临床分析

摘要

This study was purposed to explore the therapeutic efficacy and safety of VD regimen and VAD regimen for patients with multiple myeloma.The clinical data of 59 patients with multiple myeloma in our hospital from June 2008 to June 2011 were analyzed retrospectively.The 59 patients with multiple myeloma were divided randomly into VD and VAD groups.The patients in VD group were treated with bortezomib combined dexamethasone.The patients in VAD group were treated with vincristine,doxorubicin and dexamethasone.The efficacy,median survival time,1-and 2-year survival rate,and toxicity were estimated for the patients in VD group and VAD group.The results showed that the efficacy in the VD group and VAD group was 83.78％ and 59.09％ respectively.The efficacy in the VD group was significantly higher than that in the VAD group (P ＜ 0.05).The median survival time and 1-and 2-year survival rate in VD group were significantly higher than that in VAD group(P ＜0.05).The side effects in VD group mainly were haematologic toxicity,gastrointestinal disorder and peripheral neuropathy.The adverse events were mild and tolerable.The main side effects in the VAD group were haematologic toxicity,infection and hair loss.Most of the infectious in VAD group were at Grade Ⅲ-Ⅳ.It is concluded that VD regimen is an effective and safe therapy regimen for multiple myeloma,and it seems significantly superior to VAD regimen and its side effect can be tolerable for the patients.%本研究探讨VD方案和VAD方案治疗多发性骨髓瘤的临床疗效和安全性.回顾性分析2008年6月到2011年6月我院收治的59例多发性骨髓瘤患者的临床资料.根据治疗方案将患者分为VD组(38例)和VAD组(21例).VD组接受硼替佐米联合地塞米松治疗,3周为1个疗程,治疗2个疗程；VAD组接受长春新碱、阿霉素联合地塞米松治疗,4周为1疗程,治疗2个疗程.分别对两组疗效、中位生存时间、1年和2年生存率和不良反应进行评估.结果表明,VD组和VAD组治疗有效率分别为83.78％和59.09％,VD方案优于VAD方案,差异具有统计学意义(P＜0.05).VD组中位生存时间和1、2年生存率均显著高于VAD组,差异具有显著统计学意义(P＜0.05).VD组主要不良反应为血液毒性和周围神经病变,症状较轻微,在停药和对症处理后症状消失或缓解.VAD组主要不良反应为感染、脱发和血液毒性等,其中感染多以3-4度为主.结论:VD方案治疗多发性骨髓瘤疗效优于VAD方案,不良反应轻微,患者可耐受,值得临床推广使用.