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目的:比较硼替佐米联合环磷酰胺和地塞米松(PCD)与VAD传统化疗方案治疗Ⅲ期多发性骨髓瘤(multiplemyeloma,MM)的疗效及不良反应。方法:20例MM患者,临床分期均属于Ⅲ期。10例患者选择硼替佐米联合环磷酰胺和地塞米松治疗4个疗程,10例患者选择VAD方案治疗4个疗程。采用EBMT标准判定疗效,并按WHO标准判断不良反应。结果:(1)PCD组:CR40.00%(4/10),PR30.00%(3/10),MR 30.00%(3/10),总有效率为100%,(2)VAD化疗方案组:PR33.00%(3/10),MR 20.00%(2/10),PD20.00%(2/10),SD30.00%(3/10),总有效率为50%检验结果显示,两组方案对于Ⅲ期多发性骨髓瘤患者的总疗效差异有显著性(P<0.05)。与VAD化疗方案相比,PCD方案副作用轻微,包括胃肠道反应、末梢神经炎、全身乏力等,无严重血液学毒性及心脏毒性,安全性较好。结论:硼替佐米联合环磷酰胺和地塞米松(PCD)是治疗Ⅲ期MM患者的有效化疗方案。该方案不良反应轻微,疗效显著。
Objective: To compare the efficacy and side effects of bortezomib combined with cyclophosphamide and dexamethasone (PCD) and VAD traditional chemotherapy in the treatment of stage Ⅲ multiple myeloma (MM). Methods: 20 cases of MM patients, clinical stage belong to phase Ⅲ. Ten patients selected bortezomib combined with cyclophosphamide and dexamethasone for 4 courses of treatment, 10 patients for the treatment of VAD regimen for 4 courses. EBMT criteria to determine efficacy, and according to WHO standards to determine adverse reactions. Results: (1) PCD group: CR40.00% (4/10), PR30.00% (3/10) and MR30.00% (3/10), the total effective rate was 100% Group: PR33.00% (3/10), MR 20.00% (2/10), PD20.00% (2/10), SD30.00% (3/10), the total effective rate was 50% There was significant difference between the two groups in the total efficacy of patients with stage III multiple myeloma (P <0.05). Compared with the VAD chemotherapy regimen, PCD side effects of minor programs, including gastrointestinal reactions, peripheral neuritis, generalized fatigue, no serious hematological toxicity and cardiotoxicity, better safety. CONCLUSIONS: Bortezomib combined with cyclophosphamide and dexamethasone (PCD) is a potent chemotherapy regimen for patients with stage III MM. The adverse reactions to the program minor, significant effect.