| 杨福冬,青胜兰,徐锋,等.硼替佐米+环磷酰胺+地塞米松周方案与传统方案治疗初诊多发性骨髓瘤疗效及安全性评估[J].安徽医药,2020,24(11):2295-2298. |
| 硼替佐米+环磷酰胺+地塞米松周方案与传统方案治疗初诊多发性骨髓瘤疗效及安全性评估 |
| Evaluation of efficacy and safety of bortezomib + cyclophosphamide + dexamethasone weekly regimen and traditional regimen in the treatment of newly diagnosed multiple myeloma |
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| DOI：10.3969/j.issn.1009?6469.2020.11.046 |
| 中文关键词: 多发性骨髓瘤 抗肿瘤联合化疗方案 硼替佐米 环磷酰胺 疗效 不良反应 |
| 英文关键词: Multiple myeloma Antineoplastic combined chemotherapy protocols Bortezomib Cyclophosphamide Treat? ment Outcome Adverse reactions |
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| 中文摘要: |
| 目的评估硼替佐米每周一次与每周二次皮下注射联合环磷酰胺 +地塞米松治疗多发性骨髓瘤的疗效及安全性。方法选取 2015年1月至 2018年6月在德阳市人民医院初诊多发性骨髓瘤病人 60例，采用随机数字表法分为治疗组和对照组，治疗组采用硼替佐米 +环磷酰胺 +地塞米松(BCD)周方案(28例)化疗，对照组采用传统 BCD方案(32例)化疗，分别于第 2、4疗程评估两组治疗反应率及反应程度，观察不良反应，并进行对比分析。结果通过统计学分析，第2疗程结束，完全缓解(CR)+非常好的部分缓解(VGPR)治疗组明显低于对照组，差异有统计学意义(21.4%比 46.8%，P＜0.05)而总体反应(OR)治疗组与对照组比较差异无统计学意义(67.9%比 71.8%，P＞0.05)；第 4疗程结束，治疗组与对照组 CR+VGPR和，OR比较均差异无统计学意义(64.3%比 62.5%，P＞0.05，89.3%比87.5%，P＞0.05)。在药物毒性方面， 3～4级血液学毒性、周围神经毒性以及感染发生率治疗组与对照组比较分别为(10.7%比 46.9%，P＜0.05)、(14.3%比 43.8%，P＜0.05)以及(17.9%比 43.8%，P＜0.05)，均差异有统计学意义。结论 BCD方案治疗多发性骨髓瘤反应率高，但周方案具有更低的神经毒性、血液学毒性及感染发生率，安全性及耐受性更好，且不降低疗效，值得临床推广；但BCD传统方案可能更早期达到更深程度的治疗反应，也许更适合肿瘤负荷高且预计耐受性好的病人。 |
| 英文摘要: |
| Objective To evaluate the efficacy and safety of bortezomib between the once?weekly and twice?weeklysubcutaneous in?jection combined with cyclophosphamide and dexamethasone(BCD once?weekly regimen and BCD twice?weekly regimen)in the treatment of newly diagnosed multiple myeloma.Methods Sixty patients with newly diagnosed multiple myeloma Deyang People’s Hospital were randomly divided into the treatment group and the control group.The treatment group was treated with BCD weeklyregimen(28 cases)，while the control group was treated with twice weekly BCD regimen(32 cases).The response rate，response de?gree and adverse reactions of the two groups observed at the end of the second and fourth rounds of chemotherapy were compared.Results By statistical analysis，at the end of the second course，the CR+VGPR of the treatment group was significantly lower than that of the control group(21.4% vs. 46.8%，P＜0.05)，while the ORR of the treatment group was not significantly different from that of the control group(67.9% vs. 71.8%，P＞0.05).At the end of the fourth course，there was no significant difference in CR+ VGPR and OR between the treatment group and the control group(64.3% vs. 62.5%，P＞0.05；89.3% vs. 87.5%，P＞0.05).In terms of drug toxicity，the incidence of grade 3?4 hematological toxicity，peripheral neurotoxicity and infection in the treatment group was significantly lower than that in the control group(10.7% vs. 46.9%，14.3% vs. 43.8% and 17.9% vs. 43.8%，respectively)， with statistical significance.Conclusion BCD regimen has a high response rate in the treatment of multiple myeloma，but the once? weekly regimen has a lower incidence of neurotoxicity，hematotoxicity and infection，and does not reduce the efficacy，which is wor? thy of clinical promotion.However，the BCD twice?weekly regimen may achieve a deeper therapeutic response earlier，and may be more suitable for patients with high tumor load and expected good tolerance. |
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