Kim Jong Gwang, Sohn Sang Kyun, Chae Yee Soo, Kim Dong Hwan, Baek Jin Ho, Lee Kyu Bo, Lee Je-Jung, Chung Ik-Joo, Kim Hyeoung-Joon, Yang Deok-Hwan, Lee Won-Sik, Joo Young-Don, Sohn Chang-Hak
Department of Hematology/Oncology, Kyungpook National University Hospital, 50 Samduck 2-Ga, Jung-Gu, Daegu 700-721, South Korea.
Cancer Chemother Pharmacol. 2006 Jul;58(1):35-9. doi: 10.1007/s00280-005-0136-y. Epub 2005 Nov 25.
The present study evaluated the feasibility of CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone) plus etoposide and gemcitabine (CHOP-EG) as front-line chemotherapy in patients with peripheral T cell lymphomas (PTCLs).
Twenty-six patients with newly diagnosed PTCLs were enrolled into the pilot study. Treatment consisted of classical CHOP plus etoposide 100 mg/m(2) intravenously (i.v.) on day 1 and gemcitabine 600 mg/m(2) i.v. on day 1 in a 3 week interval.
Fifteen complete responses (CR, 57.7%) or one unconfirmed complete response (uCR, 3.8%) and four partial responses (PR, 15.4%) were confirmed, giving an overall response rate of 76.9% (95% CI, 58.3-96.3%). Median survival has not yet been reached, while median event free survival was 215 days at a median follow-up duration of 383 days. Estimated overall survival at 1 year was 69.6%. The most severe haematological adverse event was neutropaenia, which occurred with a grade 4 intensity in 14 patients (53.8%). Additionally, febrile neutropaenia was observed in four patients (15.4%). However, there was no treatment-related death.
The CHOP-EG regimen was found to be feasible in patients with PTCLs. For further investigation on the role of gemcitabine in the treatment of PTCLs, a more large scale phase II or phase III study is warranted.
本研究评估了环磷酰胺、阿霉素、长春新碱和泼尼松(CHOP)联合依托泊苷及吉西他滨(CHOP-EG)作为外周T细胞淋巴瘤(PTCL)患者一线化疗方案的可行性。
26例新诊断的PTCL患者纳入本初步研究。治疗方案为经典CHOP方案,联合第1天静脉注射100mg/m²依托泊苷及第1天静脉注射600mg/m²吉西他滨,每3周为一个周期。
确认15例完全缓解(CR,57.7%)或1例未确认的完全缓解(uCR,3.8%)以及4例部分缓解(PR,15.4%),总缓解率为76.9%(95%CI,58.3 - 96.3%)。中位生存期尚未达到,而中位无事件生存期为215天,中位随访时间为383天。1年时的总生存率估计为69.6%。最严重的血液学不良事件为中性粒细胞减少,14例患者(53.8%)出现4级强度。此外,4例患者(15.4%)出现发热性中性粒细胞减少。然而,没有与治疗相关的死亡。
CHOP-EG方案在PTCL患者中被发现是可行的。为进一步研究吉西他滨在PTCL治疗中的作用,有必要开展更大规模的II期或III期研究。