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目的探讨GDP方案(吉西他滨、顺铂、氟美松)治疗复发和难治性弥漫性大B细胞淋巴瘤(DLBCL)的近期疗效和毒副反应。方法 26例复发和难治性弥漫性大B细胞淋巴瘤采用GDP方案治疗:吉西他滨1000 mg/m2静脉滴注,第1、8天;顺铂25 mg/m2静脉滴注,第1～3天;氟美松40mg/d口服,第1～4天,21 d为1个周期。观察疗效和毒副反应,并随访疾病进展情况。结果 26例均能评价疗效,复发组18例总缓解率(RR)为66.7%(12/18),中位肿瘤进展时间(TTP)为7.3个月(4.5～11.2个月),难治组8例总缓解率(RR)为62.5%(5/8),中位肿瘤进展时间(TTP)为6.5个月(2.9～10.1个月),经统计学检验两组间RR及中位TTP差异均无统计学意义;且毒副反应程度较轻,毒副反应主要为白细胞和血小板减少,但均为可逆,未出现因化疗毒性而死亡患者。结论 GDP方案是治疗复发和难治性弥漫性大B细胞淋巴瘤安全有效的可行解救方案,缓解率高,化疗耐受性好。
Objective To investigate the short-term curative effect and toxicity of GDP regimen (gemcitabine, cisplatin and dexamethasone) in the treatment of recurrent and refractory diffuse large B cell lymphoma (DLBCL). Methods Twenty-six patients with recurrent and refractory diffuse large B-cell lymphoma were treated with GDP regimen: gemcitabine 1000 mg / m 2 intravenously on days 1 and 8; cisplatin 25 mg / m 2 intravenously on days 1 to 3 ; Dexamethasone 40mg / d orally, 1 to 4 days, 21 d for a cycle. Observation of efficacy and toxicity, and follow-up of disease progression. Results The curative effect was evaluated in 26 cases. The overall response rate (RR) of recurrence group was 66.7% (12/18), the median time to tumor progression (TTP) was 7.3 months (4.5 to 11.2 months) The overall response rate (RR) of 8 patients was 62.5% (5/8), and the median time to tumor progression (TTP) was 6.5 months (2.9-10.1 months). The RR and median TTP between the two groups were statistically tested No statistical significance; and mild toxicity, toxic and side effects mainly white blood cells and thrombocytopenia, but were reversible, there was no death due to chemotherapy toxicity. Conclusions The GDP regimen is a safe and effective rescue plan for the treatment of recurrent and refractory diffuse large B-cell lymphoma. The high rate of response and good chemotherapeutic tolerance.