宋春鸽,房佰俊,蔡晓萌.利妥昔单抗联合化疗治疗老年原发性中枢神经系统淋巴瘤疗效分析[J].肿瘤学杂志,2018,24(5):487-491. |
利妥昔单抗联合化疗治疗老年原发性中枢神经系统淋巴瘤疗效分析 |
Efficacy of Rituximab Combined with Chemotherapy Regimen in Treatment of Elderly Patients with Primary Central Nervous System Lymphomas |
投稿时间:2017-05-04 |
DOI:10.11735/j.issn.1671-170X.2018.05.B016 |
|
|
中文关键词: 利妥昔单抗 原发型中枢神经系统淋巴瘤 甲氨蝶呤 阿糖胞苷 地塞米松 |
英文关键词:rituximab primary central nervous system lymphoma methotrexate cytarabine dexamethasone |
基金项目:国家自然科学基金资助项目(81370661) |
|
摘要点击次数: 1872 |
全文下载次数: 480 |
中文摘要: |
摘 要:[目的] 评价利妥昔单抗联合化疗在老年原发性中枢神经系统淋巴瘤(PCNSL)中的治疗效果。[方法] 2010年10月至2013年10月收治的PCNSL患者91例,随机分为利妥昔单抗联合化疗组(R-MAD组)(n=31)给予利妥昔单抗375mg/m2、大剂量甲氨蝶呤3.5g/m2、阿糖胞苷0.5~1.0g/m2及地塞米松10mg/d治疗;靶向治疗组(n=30)采用大剂量甲氨喋呤3.5g/m2联合利妥昔单抗375mg/m2联合化疗;传统治疗组(n=31)采用全脑放疗加大剂量甲氨喋呤3.5g/m2治疗。比较各组疗效、不良反应、1年和3年生存率。[结果] (1)R-MAD组、靶向治疗组及传统治疗组完全缓解率分别为54.84%、33.33%和16.67%(χ2=10.856,P=0.004);总有效率分别为83.87%、66.67%和53.33%(χ2=6.592,P=0.037)。(2)R-MAD组的血液系统、肝脏毒性、胃肠道反应及神经毒性不良反应的发生率明显低于传统治疗组(P<0.05),R-MAD组的骨髓抑制发生率明显高于靶向治疗组及传统治疗组(P<0.05)。(3)R-MAD组1年和3年的生存率高于靶向治疗组和传统治疗组(χ2=7.715、8.139,P=0.021、0.017)。[结论]利妥昔单抗、大剂量甲氨蝶呤、阿糖胞苷及地塞米松联合应用治疗老年PCNSL可提高治疗效果,延长患者的生存时间,但不增加不良反应。 |
英文摘要: |
Abstract:[Purpose] To assess the efficacy of rituximab combined with chemotherapy regimen in treatment of elderly patients with primary central nervous system lymphomas(PCNSL). [Methods] Ninety one elderly patients with PCNSL admitted in our hospital from October 2010 to October 2013 were divided into three groups randomly. Patients in R-MAD group(n=31) received rituximab(375mg/m2),high-dose methotrexate(3.5g/m2),cytarabine(0.5~1.0g/m2) and dexamethasone(10mg/d),patients in targeted therapy group(n=30) received rituximab(375mg/m2) and high-dose methotrexate(3.5g/m2) and patients in conventional therapy group(n=30) received high-dose methotrexate(3.5g/m2) and whole brain radiotherapy. The clinical therapeutic effect,adverse effect and 1-,3-year survival rate were compared among three groups. [Results] The complete remission rates of R-MAD group,targeted therapy group and conventional therapy group were 54.84%,33.33% and 16.67%(χ2=10.856,P=0.004),and the total effective rates were 83.87%,66.67% and 53.33%(χ2=6.592,P=0.037). The incidence of blood system toxicity,liver toxicity,gastrointestinal reaction and neurotoxicity of R-MAD group was significantly lower than that of conventional treatment group(P<0.05). The incidence of myelosuppression in R-MAD group was significantly higher than that in targeted group and conventional treatment group(P<0.05). The 1- and 3-year survival rates in R-MAD group were higher than those in other two groups(χ2=7.715,8.139,P=0.021,0.017). [Conclusion] Rituximab combined with chemotherapy regimen can significantly increase therapeutic effect for elderly patients with primary central nervous system neoplasms and prolong survival time without increase in adverse reactions. |
在线阅读
查看全文 查看/发表评论 下载PDF阅读器 |