比较脂质体阿霉素与普通阿霉素对淋巴瘤患者的临床疗效
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摘要
目的探讨脂质体阿霉素对比普通阿霉素治疗方案对淋巴瘤患者临床疗效及安全性。方法选取2012年1月至2014年1月间在惠州市第一人民医院接受治疗的非霍奇金淋巴瘤(NHL)患者42例,依据随机数字表法将患者分成观察组和对照组各21例,其中观察组采用脂质体阿霉素结合翘普(CHOP)方案进行化疗,对照组采用普通阿霉素结合CHOP方案进行化疗;观察患者近、远期治疗效果和不良反应情况。结果治疗后,观察组患者总有效率为66.66%,明显高于对照组的47.62%,差异有统计学意义(P<0.05);对照组患者在血小板减少、贫血、白细胞下降、心律失常和左室功能(LVEF)%降低方面的发生率均高于观察组,差异有统计学意义(P<0.05);观察组患者总生存期(OS)、无进展生存期(PFS)和平均生存时间略高于对照组,但差异无统计学意义(P>0.05)。结论脂质体阿霉素对NHL患者效果较好,患者不良反应比普通阿霉素更低,安全可靠。
Objective To study the clinical efficacy and safety of liposomal doxorubicin compared with adriamycin in the treatment of lymphoma. Methods A total of 42 non-Hodgkin′s lymphoma(NHL)patients who were treated at the First People′s Hospital of Huizhou City between January 2012 and January 2014 were selected. According to the random number table method,the patients were divided into observation group and control group,21 cases each. Among them,the observation group was treated with liposome doxorubicin combined with CHOP chemotherapy,and the control group was treated with common adriamycin combined with CHOP chemotherapy;the patient′s near and long-term treatment effects and adverse reactions were observed. Results After treatment,the total effective rate was 66.66% in the observation group,which was significantly higher than the 47.62% in the control group(P<0.05). The thrombocytopenia,anemia,leukopenia,arrhythmia,and left ventricular ejection fraction(LVEF)% incidence of reduction of control group was higher than that ofthe observation group. The difference was statistically significant(P<0.05). The overall survival(OS),progress free survival(PFS) and mean survival time of the observation group were slightly higher than those of the control group,but the difference was not statistically significant(P>0.05). Conclusion The liposomal doxorubicin has a better effect on NHL patients. The adverse reactions of patients are lower than that of common adriamycin,which is safe and reliable.
Objective To study the clinical efficacy and safety of liposomal doxorubicin compared with adriamycin in the treatment of lymphoma. Methods A total of 42 non-Hodgkin′s lymphoma(NHL)patients who were treated at the First People′s Hospital of Huizhou City between January 2012 and January 2014 were selected. According to the random number table method,the patients were divided into observation group and control group,21 cases each. Among them,the observation group was treated with liposome doxorubicin combined with CHOP chemotherapy,and the control group was treated with common adriamycin combined with CHOP chemotherapy;the patient′s near and long-term treatment effects and adverse reactions were observed. Results After treatment,the total effective rate was 66.66% in the observation group,which was significantly higher than the 47.62% in the control group(P<0.05). The thrombocytopenia,anemia,leukopenia,arrhythmia,and left ventricular ejection fraction(LVEF)% incidence of reduction of control group was higher than that ofthe observation group. The difference was statistically significant(P<0.05). The overall survival(OS),progress free survival(PFS) and mean survival time of the observation group were slightly higher than those of the control group,but the difference was not statistically significant(P>0.05). Conclusion The liposomal doxorubicin has a better effect on NHL patients. The adverse reactions of patients are lower than that of common adriamycin,which is safe and reliable.
引文
[1]沈维娜,季冬梅,薛恺,等.聚乙二醇脂质体阿霉素在CHOP方案治疗侵袭性非霍奇金淋巴瘤中的Ⅰ期剂量递增试验的安全性探索[J].中华血液学杂志,2016,37(12):1044-1048.Shen WN,Ji DM,Xue K,et al.A phaseⅠdose-escalating trial of pegylated liposomal doxorubicin in combination with cyclophosphamide,vincristine and prednisone for aggressive nonHodgkin lymphoma[J].Chin J Hematol,2016,37(12):1044-1048.
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[3]郭智,陈惠仁,杨凯,等.脂质体阿霉素联合COP化疗方案治疗骨原发性淋巴瘤的临床研究[J].中国医药,2015,10(9):1330-1332.Guo Z,Chen HR,Yang K,et al.Clinical study of liposomal doxorubicin combined with COP chemotherapy in the treatment of primary lymphoma of bone[J].China Medicine,2015,10(9):1330-1332.
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[5]中国临床肿瘤学会抗淋巴瘤联盟,中国抗癌协会血液肿瘤专业委员会,中国抗癌协会淋巴瘤专业委员会,等.聚乙二醇化脂质体阿霉素治疗恶性淋巴瘤及多发性骨髓瘤的中国专家共识(2016年)[J].临床肿瘤学杂志,2016,21(12):1118-1125.Chinese Society of Clinical Oncology Anti-Lymphoma Union,Chinese anticancer association blood tumor professional committee,China cancer association lymphoma professional committee,et al.Consensus of Chinese experts on pegylated liposomal doxorubicin in the treatment of malignant lymphoma and multiple myeloma(2016)[J].Chinese Clinical Oncology,2016,21(12):1118-1125.
[6]赵银珠,熊屏,陈亚珠.嵌入式超声肿瘤温热治疗仪联合聚乙二醇化脂质体阿霉素干预后的兔VX2肿瘤模型中药物浓度的研究[J].上海交通大学学报:医学版,2015,35(8):1098-1101.Zhao YZ,Xiong P,Chen YZ.Study on drug concentration of rabbit VX2 tumor model intervened by combination of embedded ultrasound tumor hyperthermia instrument and pegylated liposomal doxorubicin[J].Journal of Shanghai Jiaotong University:Medical Science,2015,35(8):1098-1101.
[7]魏朝朝,陈亦乐,李乐赛.脂质体阿霉素联合奥沙利铂治疗复发性上皮型卵巢癌的有效性及安全性[J].中国医师杂志,2016,18(3):446-448.Wei CC,Chen YL,Li LS.Efficacy and safety of liposomal doxorubicin combined with oxaliplatin in the treatment of recurrent epithelial ovarian cancer[J].Journal of Chinese Physician,2016,18(3):446-448.
[8]Ricciuti G,Finolezzi E,Luciani S,et al.Combination of rituximab and nonpegylated liposomal doxorubicin(R-NPLD)as front-line therapy for aggressive non-Hodgkin lymphoma(NHL)in patients 80 years of age or older:a single-center retrospective study[J].Hematol Oncol,2018,36(1):44-48.
[9]丁昂昂,熊屏,沈国峰,等.41℃及43℃温热疗联合聚乙二醇化脂质体阿霉素治疗兔VX2肿瘤的疗效对比研究[J].上海交通大学学报:医学版,2016,36(6):799-802.Ding AA,Xiong P,Shen GF,et al.Comparative study on efficacy of 41℃or 43℃mild hyperthermia with pegylated liposomal doxorubicin for treatment of rabbit VX2 tumor[J].Journal of Shanghai Jiaotong University:Medical Science,2016,36(6):799-802.
[10]林志兰.脂质体阿霉素治疗非霍奇金淋巴瘤的临床疗效与安全性研究[J].中国医学创新,2016,13(30):92-94.Lin ZL.Clinical efficacy and safety of liposome doxorubicin in the treatment of non-Hodgkin lymphoma cancer[J].Medical Innovation of China,2016,13(30):92-94.
[11]许春,周华,陈小萍.脂质体阿霉素对淋巴瘤抑制模型的治疗效果分析[J].当代医学,2016,22(11):19-20.Xu C,Zhou H,Chen XP.Study on the effect of liposomal doxorubicin on lymphoma suppression model[J].Contemporary Medicine,2016,22(11):19-20.
[12]Simpson WG,Babbar P,Payne LF.Bilateral primary adrenal non-Hodgkin′s lymphoma without adrenal insufficiency[J].Urol Ann,2015,7(2):259-261.
[13]胡秀娟,唐超莉,何春萍.吡喃阿霉素治疗非霍奇金淋巴瘤的临床效果[J].中国医药指南,2015,13(15):13-14.Hu XJ,Tang CL,He CP.Clinical effect of non-Hodgkin′s lymphoma treated by pirarubicin[J].Guide of China Medicine,2015,13(15):13-14.
[14]Pellegrini C,Maglie R,Argnani L,et al.Impressive response to pegylated liposomal doxorubicin after allogeneic transplantation in a multi-relapsed Hodgkin′s lymphoma[J].Hematol Oncol,2016,34(1):49-51.
[15]朱婷,谢妮,刘丽桃,等.新型载阿霉素纳米粒子制备及其性能研究[J].热带医学杂志,2016,16(1):35-38.Zhu T,Xie N,Liu LT,et al.New doxorubicin nanoparticle preparation and its performance study[J].J Trop Med,2016,16(1):35-38.
[2]张欣,陆亚岚.脂质体阿霉素用于治疗小鼠淋巴瘤的效果研究[J].临床和实验医学杂志,2017,16(6):534-537.Zhang X,Lu YL.Study on the effects of liposome adriamycin on mice with lymphoma[J].Journal of Clinical and Experimental Medicine,2017,16(6):534-537.
[3]郭智,陈惠仁,杨凯,等.脂质体阿霉素联合COP化疗方案治疗骨原发性淋巴瘤的临床研究[J].中国医药,2015,10(9):1330-1332.Guo Z,Chen HR,Yang K,et al.Clinical study of liposomal doxorubicin combined with COP chemotherapy in the treatment of primary lymphoma of bone[J].China Medicine,2015,10(9):1330-1332.
[4]Pérez-Blanco JS,Santos-Buelga D,Hernández-Rivas JM,et al.Population pharmacokinetics of doxorubicin and doxorubicinol in patients diagnosed with non-Hodgkin′s lymphoma[J].Br J Clin Pharmacol,2016,82(6):1517-1527.
[5]中国临床肿瘤学会抗淋巴瘤联盟,中国抗癌协会血液肿瘤专业委员会,中国抗癌协会淋巴瘤专业委员会,等.聚乙二醇化脂质体阿霉素治疗恶性淋巴瘤及多发性骨髓瘤的中国专家共识(2016年)[J].临床肿瘤学杂志,2016,21(12):1118-1125.Chinese Society of Clinical Oncology Anti-Lymphoma Union,Chinese anticancer association blood tumor professional committee,China cancer association lymphoma professional committee,et al.Consensus of Chinese experts on pegylated liposomal doxorubicin in the treatment of malignant lymphoma and multiple myeloma(2016)[J].Chinese Clinical Oncology,2016,21(12):1118-1125.
[6]赵银珠,熊屏,陈亚珠.嵌入式超声肿瘤温热治疗仪联合聚乙二醇化脂质体阿霉素干预后的兔VX2肿瘤模型中药物浓度的研究[J].上海交通大学学报:医学版,2015,35(8):1098-1101.Zhao YZ,Xiong P,Chen YZ.Study on drug concentration of rabbit VX2 tumor model intervened by combination of embedded ultrasound tumor hyperthermia instrument and pegylated liposomal doxorubicin[J].Journal of Shanghai Jiaotong University:Medical Science,2015,35(8):1098-1101.
[7]魏朝朝,陈亦乐,李乐赛.脂质体阿霉素联合奥沙利铂治疗复发性上皮型卵巢癌的有效性及安全性[J].中国医师杂志,2016,18(3):446-448.Wei CC,Chen YL,Li LS.Efficacy and safety of liposomal doxorubicin combined with oxaliplatin in the treatment of recurrent epithelial ovarian cancer[J].Journal of Chinese Physician,2016,18(3):446-448.
[8]Ricciuti G,Finolezzi E,Luciani S,et al.Combination of rituximab and nonpegylated liposomal doxorubicin(R-NPLD)as front-line therapy for aggressive non-Hodgkin lymphoma(NHL)in patients 80 years of age or older:a single-center retrospective study[J].Hematol Oncol,2018,36(1):44-48.
[9]丁昂昂,熊屏,沈国峰,等.41℃及43℃温热疗联合聚乙二醇化脂质体阿霉素治疗兔VX2肿瘤的疗效对比研究[J].上海交通大学学报:医学版,2016,36(6):799-802.Ding AA,Xiong P,Shen GF,et al.Comparative study on efficacy of 41℃or 43℃mild hyperthermia with pegylated liposomal doxorubicin for treatment of rabbit VX2 tumor[J].Journal of Shanghai Jiaotong University:Medical Science,2016,36(6):799-802.
[10]林志兰.脂质体阿霉素治疗非霍奇金淋巴瘤的临床疗效与安全性研究[J].中国医学创新,2016,13(30):92-94.Lin ZL.Clinical efficacy and safety of liposome doxorubicin in the treatment of non-Hodgkin lymphoma cancer[J].Medical Innovation of China,2016,13(30):92-94.
[11]许春,周华,陈小萍.脂质体阿霉素对淋巴瘤抑制模型的治疗效果分析[J].当代医学,2016,22(11):19-20.Xu C,Zhou H,Chen XP.Study on the effect of liposomal doxorubicin on lymphoma suppression model[J].Contemporary Medicine,2016,22(11):19-20.
[12]Simpson WG,Babbar P,Payne LF.Bilateral primary adrenal non-Hodgkin′s lymphoma without adrenal insufficiency[J].Urol Ann,2015,7(2):259-261.
[13]胡秀娟,唐超莉,何春萍.吡喃阿霉素治疗非霍奇金淋巴瘤的临床效果[J].中国医药指南,2015,13(15):13-14.Hu XJ,Tang CL,He CP.Clinical effect of non-Hodgkin′s lymphoma treated by pirarubicin[J].Guide of China Medicine,2015,13(15):13-14.
[14]Pellegrini C,Maglie R,Argnani L,et al.Impressive response to pegylated liposomal doxorubicin after allogeneic transplantation in a multi-relapsed Hodgkin′s lymphoma[J].Hematol Oncol,2016,34(1):49-51.
[15]朱婷,谢妮,刘丽桃,等.新型载阿霉素纳米粒子制备及其性能研究[J].热带医学杂志,2016,16(1):35-38.Zhu T,Xie N,Liu LT,et al.New doxorubicin nanoparticle preparation and its performance study[J].J Trop Med,2016,16(1):35-38.