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目的:观察VPAED方案与GPAOXD方案治疗结外NK/T细胞淋巴瘤的疗效及毒副反应。方法:选择经病理、免疫组化和鼻腔部CT确诊的结外NK/T细胞淋巴瘤初治患者25例(鼻型,原发于鼻腔),应用随机数表分为A组、B组。A组14例用VPAED方案化疗(长春新碱1.4 mg/m~2,iv,d1,培门冬酶2500IU/m~2,im,d1,足叶乙甙70mg/m~2,iv,d1~3,地塞米松7mg/m~2,iv,d1~7,21天1周期),连用3周期,局部放疗54Gy,再用VPAED方案化疗3周期,随访。B组11例用GPAOXD方案化疗(吉西他滨1000 mg/m~2,iv,d1、8,培门冬酶2500IU/m~2,im,d1,奥沙利铂130 mg/m~2,iv,d1,地塞米松7mg/m~2,iv,d1~7,21天1周期),连用3周期,局部放疗54Gy,再用GPAOXD方案化疗3周期,随访。结果:化疗3周期进行疗效评价,A组CR 57.1%,RR 85.7%,2年PFS 78.6%,2年OS 78.6%;B组CR 72.7%,RR 90.9%,2年PFS 81.8%,2年OS 81.8%。两组比较,CR、RR,2年PFS、OS无差异性(P>0.05)。两组化疗毒副反应比较,B组血液WBC、PLTⅢ°~Ⅳ°骨髓抑制比A组严重,神经毒性比A组轻(P<0.05),两组肝肾功能异常、胃肠道反应无差异性。结论:两种化疗方案疗效和2年PFS、OS无差异性,需要进一步验证。
Objective: To observe the curative effect and toxicity of VPAED and GPAOXD regimen in extranodal NK / T cell lymphoma. Methods: Twenty-five patients (nasal type, primary nasal cavity) with initial extranodal NK / T cell lymphoma confirmed by pathology, immunohistochemistry and nasal CT were divided into group A and group B using random number table. A group of 14 patients treated with VPAED regimen (vincristine 1.4 mg / m ~ 2, iv, d1, pegasus 2500IU / m ~ 2, im, d1, etoposide 70mg / m ~ 2, iv, d1 ~ 3, dexamethasone 7mg / m ~ 2, iv, d1 ~ 7, 21 days and 1 cycle) for 3 weeks, local radiotherapy 54Gy, and then VPAED chemotherapy 3 cycles, follow-up. In group B, 11 cases were treated with GPAOXD chemotherapy (Gemcitabine 1000 mg / m 2, iv, d 1.8, pegaspargase 2500 IU / m 2, im, d 1, oxaliplatin 130 mg / d1, dexamethasone 7mg / m ~ 2, iv, d1 ~ 7,21 days a cycle), once every 3 cycles, local radiotherapy 54Gy, then 3 cycles of GPAOXD chemotherapy, follow-up. Results: The efficacy of 3 cycles of chemotherapy was evaluated. CR of 57.1%, RR of 85.7%, 78.6% of 2 years and 78.6% of 2 years of OS in group A, CR 72.7%, RR 90.9%, 2 years PFS 81.8%, 2 years OS 81.8%. Two groups, CR, RR, 2-year PFS, OS no difference (P> 0.05). Compared with group A, the bone marrow suppression of WBC and PLT Ⅲ ° ~ Ⅳ ° in group B was more serious than that in group A, and the neurotoxicity was lower in group B than in group A (P <0.05). There was no difference in liver and kidney function between the two groups Sex. Conclusion: The efficacy of two chemotherapy regimens and 2 years PFS, OS no difference, need further verification.