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目的:探讨DICE方案联合恩度治疗复发难治弥漫大B细胞淋巴瘤(difuse large B-cell lymphoma,DLBCL)的疗效和安全性。方法:全组15例患者均接受DICE方案联合恩度治疗。地塞米松10 mg/d静脉给药d 1~4;异环磷酰胺1 g·m~(-2)·d~(-1)静脉给药(给予美司钠解救)d 1~4;顺铂25 mg·m~(-2)·d~(-1)静脉给药d 1~4;依托泊苷60 mg·m~(-2)·d~(-1)静脉给药d 1~4。恩度7.5 mg·m~(–2)·d~(–1)静脉给药d 1~14。每21~28 d为1个化疗周期。2个周期后评价近期疗效和不良反应,分析生存情况。结果:2009年1月—2011年9月共入组15例患者中,其中难治患者11例(73.3%),复发患者4例(26.7%)。2例(13.3%)获完全缓解,2例(13.3%)获部分缓解,总有效率为26.7%。在各项临床因素中,性别(P=0.011)、国际预后指数(P=0.033)和血清乳酸脱氢酶水平(P=0.011)对总有效率有明显影响。全组患者的中位生存时间为10个月,1年总生存率为46.7%;中位治疗失败时间为2个月,1年治疗失败率为26.7%。主要不良反应为骨髓抑制,Ⅲ~Ⅳ度白细胞和中性粒细胞下降均为11例(78.6%)。结论:DICE方案联合恩度治疗复发难治DLBCL有一定疗效,未发现显著不良反应,不良反应也未明显增加。今后可扩大病例数开展进一步研究。
Objective: To investigate the efficacy and safety of DICE combined with Endometriosis in the treatment of difuse large B-cell lymphoma (DLBCL). Methods: The whole group of 15 patients received DICE combined with Endue treatment. Dexamethasone 10 mg / d intravenously d 1 ~ 4; ifosfamide 1 g · m ~ (2) · d ~ (-1) intravenous administration (given mesto rescue) d 1 ~ 4; Cisplatin 25 mg · m -2 · d -1 intravenously d 1 ~ 4; etoposide 60 mg · m -2 · d -1 intravenously d 1 ~ 4. Endurance 7.5 mg · m ~ (-2) · d ~ (-1) intravenous d 1 ~ 14. Every 21 ~ 28 d for a chemotherapy cycle. After 2 cycles to evaluate the recent efficacy and adverse reactions, analysis of survival. Results: Of the 15 patients enrolled between January 2009 and September 2011, 11 were refractory (73.3%) and 4 (26.7%) were relapsed. Two patients (13.3%) were completely relieved and two patients (13.3%) were partially relieved, with a total effective rate of 26.7%. Among all the clinical factors, gender (P = 0.011), international prognostic index (P = 0.033) and serum lactate dehydrogenase level (P = 0.011) had a significant effect on the total effective rate. The median survival time was 10 months and the 1-year overall survival rate was 46.7%. The median treatment failure time was 2 months and the 1-year treatment failure rate was 26.7%. The main adverse reaction was myelosuppression. Grade Ⅲ ~ Ⅳ leukopenia and neutrophils decreased in 11 cases (78.6%). Conclusion: DICE combined with Endue treatment of refractory DLBCL recurrence have a certain effect, no significant adverse reactions, adverse reactions did not increase significantly. In the future can expand the number of cases for further study.