论文部分内容阅读
目的 探讨不同化疗方案对多发性骨髓瘤(MM)患者的治疗效果。方法 回顾性分析了206例MM患者的治疗情况,对不同治疗方案的疗效进行比较。结果 200例药物治疗患者的中位生存期为30. 5个月, 3年和5年实际生存率分别为32. 01%和15. 8%。195例行常规化疗患者的总有效率为45. 6%,其中完全缓解率14. 9% (29例),部分缓解率30. 8% ( 60例)。联合化疗组的总有效率为50. 3%,明显高于MP(马法兰和泼尼松)方案组的总有效率(30. 4% ) (P<0. 05);这两组的中位生存期分别为30. 5个月和30. 0个月、3年和5年生存率分别为35. 0%和22. 0%, 16. 7%和13. 2%,差异无统计学意义(P值均>0. 05)。合并干扰素治疗组的有效率为53. 6% ,中位生存期52. 0个月,与未用干扰素治疗组(分别为34. 4%, 27. 0个月)相比,有效率提高(P<0. 05)、生存期延长(P<0. 01)。合并沙利度胺治疗的总有效率为65. 5%。6例外周血造血干细胞移植患者有5例存活,平均生存期为(73. 0±12. 5)个月。结论 联合化疗的有效率高于MP方案,但两组的总生存率差异无统计学意义。干扰素能使化疗有效率增加,中位生存期延长。沙利度胺也能够提高MM患者的治疗有效率。对于年龄较轻、一般状态较好的患者,自体干细胞移植可明显提高生存期。
Objective To investigate the therapeutic effect of different chemotherapy regimens on patients with multiple myeloma (MM). Methods A retrospective analysis of the treatment of 206 cases of MM patients, the efficacy of different treatment options were compared. Results The median survival of 200 drug-treated patients was 30. 5 months, 3 years and 5 years the actual survival rates were 32. 01% and 15.8%. The total effective rate of 195 routine chemotherapy patients was 45.6%, of which the complete remission rate was 14.9% (29 cases) and the partial remission rate was 30.8% (60 cases). The total effective rate in combination chemotherapy group was 50.3%, which was significantly higher than that in MP (melphalan and prednisone) group (30.4%) (P <0.05). The median The survival rates were 30.5 months and 30. 0 months, respectively. The 3-year and 5-year survival rates were 35.0%, 22.0%, 16. 7% and 13.2% respectively, with no significant difference (P> 0.05). Interferon therapy group was 53.6% effective rate, the median survival of 52. 0 months, compared with non-interferon treatment group (34.4%, 27. 0 months), the effective rate (P <0.05), and prolonged survival (P <0.01). 5%. The total effective rate of treatment with thalidomide was 65.5%. Five of six patients with peripheral blood stem cell transplantation survived with an average survival of (73.0 ± 12.5) months. Conclusions The combined chemotherapy is more effective than MP, but there is no significant difference in the overall survival between the two groups. Interferon can increase the efficiency of chemotherapy, the median survival increased. Thalidomide can also increase the effectiveness of treatment in patients with MM. For younger patients, the general state of patients with better, autologous stem cell transplantation can significantly improve survival.