摘要
目的 探讨减低剂量及标准剂量硼替佐米联合阿霉素、地塞米松治疗不同类型多发性骨髓瘤（MM）的近期疗效及安全性.方法 对52例初诊、复发及难治MM患者给予硼替佐米1.3 mg/m2（标准剂量组,26例）或1.0～1.1 mg/m2（减低剂量组,26例）,第1,4,8,11天快速静脉注射,阿霉素10 mg/m2,第1～4天静脉注射,地塞米松40mg/d,第1～4天静脉滴注,治疗1～6个疗程.比较两组患者的疗效和不良反应.结果 标准剂量组治疗总反应率为80.8％（21/26）,与减低剂量组的88.5％（23/26）比较差异无统计学意义（P=0.739）;两组白细胞、血小板减少发生率比较差异均无统计学意义[23.1％（6/26）比15.4％（4/26）,P=0.281;11.5％（3/26）比7.7％（2/26）,P=0.620];标准剂量组与减低剂量组比较,由硼替佐米诱导的Ⅲ～Ⅳ级周围神经病[15.4％（4/26）比3.8％（1/26）,P=0.038）]、带状疱疹[26.9％（7/26）比7.7％（2/26）,P=0.029]、乏力[38.5％（10/26）比15.4％（4/26）,P=0.045]及腹胀发生率[19.2％（5/26）比3.8％（1/26）,P=0.028]前者均高于后者,差异有统计学意义.结论 减低剂量联合疗法治疗初诊和复发、难治MM患者的疗效反应与标准剂量类似,但患者对减低剂量联合方案具有更好的耐受性.
Objective To compare the efficacy and safety of standard or reduced doses of bortezomib combined with adriamycin and dexamethasone in patients with multiple myeloma （MM）.Methods Fifty-two newly diagnosed,refractory and relapsed patients received bortezomib [1.3 mg/m2 （standard dose group,26 patients） or 1.0-1.1 mg/m2 （reduced dose group,26 patients） on day 1st,4th,8th and 11 th],and adriamycin （10 mg/m2） plus dexamethasone （40 mg/d） on day 1 st-4th,and were treated for 1-6 courses.Adverse events were graded and compared.Results After treatment,the overall response rate of standard dose group [80.8%（21/26）] and reduced dose group [88.5%（23/26）] had no significant difference （P =0.739）.The rate of neutropenia and thrombocytopenia in two groups had no significant difference[23.1%（6/26） vs.15.4%（4/26）,P=0.281 ; 11.5%（3/26） vs.7.7%（2/26）,P=0.620].The rate of Ⅲ-Ⅳ grade peripheral nerve disease,herpes zoster,lack of power and abdominal distension in standard dose group were significantly higher than those in reduced dose group [15.4%（4/26） vs.3.8%（1/26）,P =0.038;26.9%（7/26） vs.7.7%（2/26）,P =0.029;38.5%（10/26） vs.15.4%（4/26）,P=0.045; 19.2%（5/26）vs.3.8% （1/26）,P =0.028].Conclusion Reduced dose of bortezomib appears to result in similar overall response rate,but better tolerance and safety compared with standard dose.
出处
《中国医师进修杂志》
2014年第7期43-45,共3页
Chinese Journal of Postgraduates of Medicine
