吉西他滨联合奥沙利铂对多程化疗方案失败的淋巴瘤患者的疗效及安全性评估

[Efficacy and safety evaluation of gemcitabine combined with oxaliplatin in lymphoma patients after failure of multiple chemotherapy regimens].

作者信息

Yang Jianliang, Shi Yuankai, He Xiaohui, Zhou Shengyu, Dong Mei, Liu Peng, Zhang Changgong, Qin Yan, Yang Sheng, Gui Lin

机构信息

Department of Medical Oncology, Cancer Institute/Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College; Beijing Key Laboratory of Clinical Research of Anti-Cancer Targeted Drugs. Beijing 100021, China.

出版信息

Zhonghua Zhong Liu Za Zhi. 2014 Feb;36(2):137-40.

PMID:24796464

Abstract

OBJECTIVE

To evaluate the efficacy and safety of gemcitabine combined with oxaliplatin (GEMOX) in lymphoma patients after failure of multiple chemotherapy regimens.

METHODS

The clinical data of 27 lymphoma patients, who received GEMOX regimen after failure of two or more prior chemotherapy regimens, were retrospectively reviewed. The predictive factors related to the clinical efficacy of GEMOX regimen were explored.

RESULTS

The efficacy could be evaluated in 24 patients. Complete response was obtained in 4 patients (16.7%), partial response in 7 patients (29.1%), stable disease in 6 patients (25.0%), and progressive disease in 7 patients (29.1%), with an overall response rate of 45.8%. Among the eleven CR and PR patients, four patients were with diffuse large B cell lymphoma, four patients with Hodgkin's lymphoma, one with peripheral T cell lymphoma, one with mantle cell lymphoma and one with gastric mucosa-associated lymphoid tissue lymphoma. The median PFS time of the whole group was 8 months (95%CI, 1.6-14.4 months). For 11 CR and PR patients who had response to the GEMOX regimen, the median PFS time was 19 months (95%CI, 11.1-26.8 months). Major adverse response was hematologic toxicity. Among them, grade III or IV neutropenia appeared in 16 patients (59.3%), and grade III or IV thrombocytopenia appeared in 11 patients (40.7%). The sensitivity to the last chemotherapy was related to the efficacy of GEMOX regimen. The response rate was 83.3% in patients who had response to the last chemotherapy, and only 31.2% in the patients who failed to the last chemotherapy (P = 0.001).

CONCLUSIONS

GEMOX regimen can get a better response rate in lymphoma patients after failure of multiple chemotherapy regimens, and with a good tolerance and acceptable safety. Some patients can get long-term survival. Patients sensitive to the last chemotherapy are more likely to benefit from GEMOX regimen.

摘要

目的

评估吉西他滨联合奥沙利铂（GEMOX）方案对多程化疗失败后的淋巴瘤患者的疗效及安全性。

方法

回顾性分析27例经两个或以上化疗方案失败后接受GEMOX方案治疗的淋巴瘤患者的临床资料，探讨与GEMOX方案临床疗效相关的预测因素。

结果

24例患者可评估疗效。4例（16.7%）获得完全缓解，7例（29.1%）部分缓解，6例（25.0%）病情稳定，7例（29.1%）病情进展，总缓解率为45.8%。在11例CR和PR患者中，4例为弥漫大B细胞淋巴瘤，4例为霍奇金淋巴瘤,1例为外周T细胞淋巴瘤，1例为套细胞淋巴瘤，1例为胃黏膜相关淋巴组织淋巴瘤。全组患者的中位无进展生存期为8个月（95%CI，1.6 - 14.4个月）。对GEMOX方案有效的11例CR和PR患者的中位无进展生存期为19个月（95%CI，11.1 - 26.8个月）。主要不良反应为血液学毒性，其中Ⅲ/Ⅳ度中性粒细胞减少16例（59.3%），Ⅲ/Ⅳ度血小板减少11例（40.7%）。对末次化疗的敏感性与GEMOX方案疗效相关，对末次化疗有效的患者缓解率为83.3%，对末次化疗无效的患者缓解率仅为31.2%（P = 0.001）。