Palmer M C, Fitzharris B M, Robinson B A, Atkinson C H, Colls B M
Department of Clinical Oncology, Christchurch Hospital.
N Z Med J. 1988 May 25;101(846):255-8.
We have reviewed the management of high grade nonHodgkin's lymphoma in a regional cancer centre over an eight year period. Forty-seven patients were referred with diffuse histiocytic, diffuse undifferentiated and lymphoblastic lymphomas or true histiocytic neoplasms. Twenty-six were treated with doxorubicin, cyclophosphamide, vincristine and prednisone (ACOP). The overall complete remission rate was 73%, 83% for stage I and II disease and 62% for stages III and IV. Kaplan-Meier analysis shows 49% surviving at a median follow up time of 23 months (range 1-108 months) with 11 of the 13 survivors continuously disease free. Toxicity was not severe except for one treatment-related death. Most were treated as outpatients. Patients 70 years of age or older were treated less intensively and only 3 of 14 survive. We conclude that treatment with ACOP is simple and effective in the management of high grade nonHodgkin's lymphoma. Currently our protocol includes the same agents, but at higher dosage, with the addition of methotrexate; we believe this should be tested against the recent more intensive, multiagent alternating regimens in a prospective, randomised clinical trial.
我们回顾了某地区癌症中心在八年期间对高级别非霍奇金淋巴瘤的治疗情况。47例患者被诊断为弥漫性组织细胞性、弥漫性未分化性和淋巴母细胞性淋巴瘤或真性组织细胞性肿瘤。26例患者接受了阿霉素、环磷酰胺、长春新碱和强的松（ACOP）治疗。总体完全缓解率为73%，I期和II期疾病的缓解率为83%，III期和IV期为62%。Kaplan-Meier分析显示，在中位随访时间23个月（范围1 - 108个月）时，49%的患者存活，13名幸存者中有11名持续无病。除1例与治疗相关的死亡外，毒性并不严重。大多数患者作为门诊患者接受治疗。70岁及以上的患者治疗强度较低，14名患者中只有3名存活。我们得出结论，ACOP治疗在高级别非霍奇金淋巴瘤的管理中简单有效。目前我们的方案包括相同的药物，但剂量更高，并添加了甲氨蝶呤；我们认为应该在前瞻性随机临床试验中与最近更强化的多药交替方案进行对比测试。
