论文部分内容阅读
目的 为了提高儿童急性淋巴细胞白血病 (ALL)和非霍奇金淋巴瘤 (NHL)的远期疗效 ,在总结国内外研究进展的基础上 ,设计制定同济 95方案 (TJ95 ) ,并以多年临床观察资料分析与判定其远期疗效。方法 儿童ALL和晚期NHL共 5 1例 ,其中ALL 32例 ,晚期NHL 19例。分别应用TJ95 1方案治疗儿童ALL、Ⅳ期和Ⅲ期T细胞淋巴瘤 ;TJ95 2方案治疗Ⅲ期B细胞淋巴瘤。采用积极的化疗副反应综合防治措施 ,以保证强烈化疗顺利进行 ,随访观察远期疗效。结果 初治完全缓解 (CR)率为 10 0 %。可供分析远期疗效的病例共 4 8例 (3例失访 ) ,其中 38例仍持续完全缓解 (CCR)中 ,平均CCR时间为 6 0 1个月 ,CCR率为 79 17% ;按Kaplan Meier函数分析法预测 6年以上CCR率为 79 0 5 %。因采用有效的化疗副反应综合防治措施 ,未发生化疗相关死亡。结论 TJ95方案远期疗效显著 ,CCR率接近发达国家水平。毒副反应可以有效防治 ,患儿能够耐受 ,适用于我国儿童ALL和晚期NHL的长期治疗 ,值得推广。
Objective To improve the long-term efficacy of acute lymphoblastic leukemia (ALL) and non-Hodgkin’s lymphoma (NHL) in children, and to summarize the research progress at home and abroad, the TJ95 program was designed and developed, and based on years of clinical observation Data analysis and determine its long-term efficacy. Methods A total of 51 children with ALL and advanced NHL were enrolled, including 32 ALL patients and 19 patients with advanced NHL. The TJ95 1 regimen was used to treat childhood ALL, stage Ⅳ and stage Ⅲ T cell lymphoma, respectively. The TJ95 2 regimen was used to treat stage Ⅲ B cell lymphoma. Adopt active comprehensive treatment of side effects of chemotherapy measures to ensure the smooth progress of strong chemotherapy, follow-up observation of long-term efficacy. Results The initial complete remission (CR) rate was 100%. Forty-eight cases (3 lost cases) were analyzed for long-term efficacy, of whom 38 cases were still in complete remission (CCR) with an average CCR of 6.01 months and a CCR rate of 79.17% Meier function analysis predicted the CCR rate of 6 years or more was 79 0 5%. Due to the effective comprehensive treatment of side effects of chemotherapy, no chemotherapy-related deaths occurred. Conclusion Long-term curative effect of TJ95 program is remarkable, CCR rate is close to that of developed countries. Toxic and side effects can be effectively controlled, children can tolerate, for our children’s ALL and advanced NHL long-term treatment, it is worth promoting.