含聚乙二醇脂质体多柔比星的R-CHOP方案治疗老年初治弥漫大B细胞淋巴瘤的疗效及安全性

摘要

Objective:To investigate the efficacy and safety of R - CHOP regimen containing pegylated liposomal doxorubicin (PLD)in the treatment of elderly patients with primary diffuse large B - cell lymphoma(DLBCL). Meth-ods:Clinical data of 64 cases of DLBCL in our hospital from January 2011 to May 2014 were analyzed retrospectively. 34 cases received R - CHOP regimen containing PLD,30 cases received standard R - CHOP regimen. The treatment efficiency,survival rate,general adverse reactions and cardiac toxicity were compared between these two groups. Re-sults:Of the 34 cases patients with R - CHOP regimen containing PLD,complete remission (CR)rate was 52. 9%(18 / 34)and overall response (OR)rate was 82. 4% (28 / 34). The 1 - year,2 - year and 3 - year overall survival (OS)rates were 91. 2%,79. 4% and 67. 6% respectively. Of the 30 cases patients with standard R - CHOP regime, complete remission rate was 46. 7% (14 / 30)and overall response rate was 73. 3% (22 / 30). The 1 - year,2 - year and 3 - year overall survival rates were 86. 7%,66. 7% and 43. 3% respectively. There was no significant difference between the two groups in the rate of CR and OR (P > 0. 05). The 3 - year survival rate of patients with R - CHOP regimen containing PLD was significantly higher than that of the standard R - CHOP regimen group,and the difference was statistically significant (P < 0. 05). The most common adverse reactions in these two groups were gastrointestinal reaction and neutropenia. The cardiac toxicity of R - CHOP regimen containing PLD group,such as myocardial infarc-tion,cardiac dysfunction and new electrocardiographic abnormalities,was significantly lower than that of standard R -CHOP regimen group. Conclusion:Compared with doxorubicin,R - CHOP regimen containing PLD can significantly reduce the cardiac toxicity induced by chemotherapy in elderly patients with DLBCL,and can also improve the long -term survival of patients.%目的:探讨应用含聚乙二醇脂质体多柔比星(PLD)的R-CHOP方案治疗老年初治弥漫大B细胞淋巴瘤(DLBCL)的疗效及安全性.方法:收集我院2011年1月至2014年5月收治的64例老年DLBCL患者的临床资料,34例应用含PLD的R-CHOP方案化疗,30例应用传统R-CHOP方案化疗,对比分析两组患者的治疗有效率、生存率、一般不良反应及心脏毒性.结果:34例应用含PLD的R-CHOP方案化疗患者,CR 18例(52.9%),总有效率(OR)为82.4%.1、2、3年的总生存率(OS)分别为91.2%、79.4%及67.6%.30例应用传统R-CHOP方案化疗患者,CR 14例(46.7%),OR为73.3%.1、2、3年的OS分别为86.7%、66.7%及43.3%.两组CR率及OR率相比较,差异无统计学意义(P>0.05).含PLD的R-CHOP方案化疗组患者3年生存率明显高于传统R-CHOP方案化疗组患者,且差异有统计学意义(P<0.05).两组患者出现的一般不良反应最常见的为胃肠道反应及中性粒细胞减少.含PLD的R-CHOP方案化疗组患者心脏毒性反应,如心肌梗死、心功能不全及新发心电图异常与传统R-CHOP方案化疗组患者相比明显降低.结论:与多柔比星相比,含PLD的R-CHOP方案能明显减轻老年DLBCL患者化疗所致的心脏毒性,安全性较好,并可改善患者的长期生存.