Gu Y, Yuan Y H, Shi Q L, Qu X Y, Xu J, Guo R, Xu J D, Li J Y, Chen L J
Department of Hematology, the First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing 210029, China.
Zhonghua Xue Ye Xue Za Zhi. 2017 Apr 14;38(4):279-284. doi: 10.3760/cma.j.issn.0253-2727.2017.04.004.
To observe the efficacy and safety of CTD (cyclophosphamide, thalidomide, dexamethasone) and PCD (bortezomib, cyclophosphamide, dexamethasone) regimens in treatment of patients with newly diagnosed multiple myeloma (NDMM) . A retrospective analysis was carried out on 88 cases of NDMM patients admitted to our hospital from July 2013 to January 2016, including 49 cases in CTD group and 39 cases in PCD group. The outcomes of two different regimens were analyzed, including response, prognosis, and adverse events. The total overall remission rates (ORR, better than PR) of CTD and PCD were 65.3% (32/49) and 84.6% (33/39) , while very good partial response (VGPR) were 30.6% (15/49) and 53.8% (21/39) , and differences were statistically significant (=0.041, =0.028) . The median follow-up was 11.5 (3-33) months. The median progression-free survival (PFS) was (23.0±4.5) months in CTD groups, but it was not achieved in PCD group, with statistically significant differences (=0.050) . Medial overall survival was not achieved in both two groups, without statistically significant difference (=0.257) . There were statistical differences between patients with minor response (MR) and patients without MR in medium OS in CTD group (=0.005) , and there were statistical difference between patients with VGPR and without VGPR in medium OS in CTD group (=0.042) . Infection was a common adverse event in two groups. The incidences of peripheral neuropathy and herpes zoster were markedly higher in PCD group than CTD group, and the incidences of thrombus, palpation and rash, etc., were higher in CTD group. Both CTD and PCD regimens were effective first-line induction chemotherapy choice for NDMM. PCD regimen is better than CTD in treatment power and deep remission.
观察环磷酰胺、沙利度胺、地塞米松（CTD）方案和硼替佐米、环磷酰胺、地塞米松（PCD）方案治疗初诊多发性骨髓瘤（NDMM）患者的疗效及安全性。对2013年7月至2016年1月我院收治的88例NDMM患者进行回顾性分析，其中CTD组49例，PCD组39例。分析两种不同方案的治疗效果，包括缓解情况、预后及不良事件。CTD组和PCD组的总总体缓解率（ORR，优于PR）分别为65.3%（32/49）和84.6%（33/39），非常好的部分缓解（VGPR）分别为30.6%（15/49）和53.8%（21/39），差异有统计学意义（=0.041，=0.028）。中位随访时间为11.5（3 - 33）个月。CTD组的中位无进展生存期（PFS）为（23.0±4.5）个月，PCD组未达到，差异有统计学意义（=0.050）。两组均未达到中位总生存期，差异无统计学意义（=0.257）。CTD组中微小缓解（MR）患者与无MR患者的中位总生存期有统计学差异（=0.005），CTD组中VGPR患者与无VGPR患者的中位总生存期有统计学差异（=0.042）。感染是两组常见的不良事件。PCD组周围神经病变和带状疱疹的发生率明显高于CTD组，CTD组血栓、触痛和皮疹等的发生率较高。CTD和PCD方案均是NDMM有效的一线诱导化疗选择。PCD方案在治疗强度和深度缓解方面优于CTD方案。
