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吉西他滨联合奥沙利铂、L-天冬酰胺酶和地塞米松治疗初诊结外NK/T细胞淋巴瘤患者的疗效

Efficacy of gemcitabine combined with oxaliplatin, L-asparaginase and dexamethasone in patients with newly-diagnosed extranodal NK/T-cell lymphoma.

作者信息

Guo Hong-Qiang, Liu Lei, Wang Xin-Feng, Lin Tong-Yu, Yao Shu-Na, Yao Zhi-Hua, Yang Shu-Jun

机构信息

Department of Medical Oncology, The Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, Henan 450008, P.R. China ; Department of Medical Oncology, Henan Province Cancer Hospital, Zhengzhou, Henan 450008, P.R. China.

Department of Medical Oncology, Cancer Center, Sun Yat-sen University, Guangzhou, Guangdong 510060, P.R. China.

出版信息

Mol Clin Oncol. 2014 Nov;2(6):1172-1176. doi: 10.3892/mco.2014.368. Epub 2014 Aug 1.

Abstract

There is currently no standard first-line regimen for patients with extranodal natural killer (NK)/T-cell lymphoma (ENKTCL). In this study, we investigated the efficacy and toxicity of gemcitabine (GEM) combined with oxaliplatin (L-OHP), L-asparaginase (L-ASP) and dexamethasone (DXM) (GOLD regimen) as a systemic treatment scheme for newly-diagnosed ENKTCL cases. A total of 55 patients were recruited at the Henan Province Cancer Hospital and the Cancer Center of Sun Yat-sen University between May, 2008 and August, 2012. The GOLD regimen included a 14-day treatment cycle with GEM (1,000 mg/m) on day 1, L-OHP (100 mg/m) on day 1, L-ASP (10,000 U/m) on days 1-5 and DXM (20 mg b.i.d.) on days 1-4. The response rate, survival rate and treatment toxicity were analyzed. The overall response rate was 91% (48/55) with a complete response in 62% (34/55) and a partial response in 29% (15/55) of the patients. For all patients, the 1-, 2- and 3-year progression-free survival (PFS) rate was 86, 64 and 57% and the overall survival (OS) 91, 80 and 74%, respectively. The 1-year PFS in patients with stage I/II vs. those with III/IV disease was 87 vs. 66% (P<0.001) and the 1-year OS was 98 vs. 75%, respectively (P<0.001). No chemotherapy-related mortality or severe complications were recorded. In conclusion, the GOLD regimen was found to be highly effective and safe for the treatment of patients with newly-diagnosed ENKTCL.

摘要

目前,结外自然杀伤(NK)/T细胞淋巴瘤(ENKTCL)患者尚无标准的一线治疗方案。在本研究中,我们探讨了吉西他滨(GEM)联合奥沙利铂(L-OHP)、L-天冬酰胺酶(L-ASP)和地塞米松(DXM)(GOLD方案)作为新诊断ENKTCL病例全身治疗方案的疗效和毒性。2008年5月至2012年8月期间,河南省肿瘤医院和中山大学肿瘤防治中心共招募了55例患者。GOLD方案包括一个14天的治疗周期,第1天使用GEM(1000mg/m²),第1天使用L-OHP(100mg/m²),第1 - 5天使用L-ASP(10000U/m²),第1 - 4天使用DXM(20mg,每日两次)。分析了缓解率、生存率和治疗毒性。总缓解率为91%(48/55),其中完全缓解率为62%(34/55),部分缓解率为29%(15/55)。所有患者的1年、2年和3年无进展生存率(PFS)分别为86%、64%和57%,总生存率(OS)分别为91%、80%和74%。I/II期患者与III/IV期患者的1年PFS分别为87%和66%(P<0.001),1年OS分别为98%和75%(P<0.001)。未记录到化疗相关死亡或严重并发症。总之,GOLD方案被发现对新诊断的ENKTCL患者治疗具有高效性和安全性。

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