Huang Limin, Yuan Bin, Wu Haixia, Chu Hongliang, Liu Yayun, Wu Shuang, Li Hong, Lu He, Chen Hui
Department of Oncology, Guizhou Provincial People's Hospital, Guiyang, Guizhou, China.
Department of Hematology, Guizhou Cancer Hospital, Guiyang, Guizhou, China.
Clin Lymphoma Myeloma Leuk. 2017 Mar;17(3):152-158. doi: 10.1016/j.clml.2016.12.003. Epub 2017 Jan 10.
In this study we evaluated the efficacy of an L-asparaginase-based LOP (L-asparaginase, vincristine, and dexamethasone) regimen in extranodal Natural Killer (NK)/T-cell lymphoma (ENKTL) patients in the Guizhou province of China.
Forty-eight patients were treated with the LOP (L-asparaginase, vincristine and dexamethasone) regimen chemotherapy (CT) and 32 patients with the CHOP (cyclophosphamide, tetrahydropyanyl adriamycin, vincristine, and prednisone) regimen. These patients then received involved-field radiotherapy (RT) with the doses of DT = 49-59 Gy.
A significant improvement of clinical end points with the LOP regimen was noticed compared with the CHOP regimen: 33 (68.8%) versus 16 (50.0%) for complete responses; 10 (20.8%) versus 5 (15.6%) for partial responses. There were statistical differences in objective response rates (43 [89.6%] for LOP vs. 21 [65.6%] for CHOP; P = .009), 3 years of overall survival (42 [87.5%] for LOP vs. 20 [62.5%] for CHOP; P = .006) and progression-free survival (32 [79.2%] for LOP vs. 16 [50.0%] for CHOP; P = .007).
The results showed that the LOP regimen is safe and much more efficient than the CHOP regimen for stage IIE ENKTL patients. They indicate that the LOP regimen is a satisfying alternative protocol among the other L-asparaginase-based regimens reported so far, such as SMILE (dexamethasone, methotrexate, ifosfamide, L-asparaginase, and etoposide), GELOX (gemcitabine, oxaliplatin, and L-asparaginase), CHOP-L, and sandwich (CT, then RT, then CT).
在本研究中，我们评估了基于左旋门冬酰胺酶的LOP（左旋门冬酰胺酶、长春新碱和地塞米松）方案对中国贵州省结外自然杀伤（NK）/T细胞淋巴瘤（ENKTL）患者的疗效。
48例患者接受LOP（左旋门冬酰胺酶、长春新碱和地塞米松）方案化疗（CT），32例患者接受CHOP（环磷酰胺、吡喃阿霉素、长春新碱和泼尼松）方案。这些患者随后接受累及野放疗（RT），剂量为DT = 49 - 59 Gy。
与CHOP方案相比，LOP方案的临床终点有显著改善：完全缓解率为33例（68.8%）对16例（50.0%）；部分缓解率为10例（20.8%）对5例（15.6%）。客观缓解率（LOP方案为43例[89.6%]，CHOP方案为21例[65.6%]；P = .009）、3年总生存率（LOP方案为42例[87.5%]，CHOP方案为20例[62.5%]；P = .006）和无进展生存率（LOP方案为32例[79.2%]，CHOP方案为16例[50.0%]；P = .007）存在统计学差异。
结果表明，对于IIE期ENKTL患者，LOP方案比CHOP方案更安全且效率更高。这表明在目前报道的其他基于左旋门冬酰胺酶的方案中，如SMILE（地塞米松、甲氨蝶呤、异环磷酰胺、左旋门冬酰胺酶和依托泊苷）、GELOX（吉西他滨、奥沙利铂和左旋门冬酰胺酶）、CHOP-L和夹心方案（CT，然后RT，然后CT），LOP方案是一个令人满意的替代方案。
