【摘要】：目的:探討基于硼替佐米化療方案治療多發(fā)性骨髓瘤(multiple myeloma,MM)的療效及安全性。方法:回顧性分析2009年11月-2016年11月住廣西醫(yī)科大學(xué)第一附屬醫(yī)院接受4個療程及以上基于硼替佐米化療方案的51例初治MM患者的臨床資料,隨訪生存患者的基本情況,采用Kaplan-Meier法進行生存分析,采用Log-Rank檢驗分析確定影響預(yù)后的相關(guān)因素。結(jié)果:1、基于硼替佐米化療方案治療MM的療效:(1)本組51例MM患者完成4周期化療時評價療效,全組患者的完全緩解率(Complete remission,CR)及總反應(yīng)率(Overall response rate,ORR)分別為23.5%和86.3%;(2)本組患者3年生存率、5年生存率分別為68.7%和31.1%;(3)本組患者的中位總生存期(overall survival,OS)、中位無疾病進展生存期(progression free survival,PFS)分別為61個月和32個月。2、影響基于硼替佐米化療方案治療MM療效的相關(guān)因素:(1)化療取得CR及非常好的部分緩解(Very good partial remission,VGPR)患者組的PFS顯著長于未取得VGPR組(40個月VS 16個月,P=0.001);(2)血清β2微球蛋白5.5mg/L患者組OS顯著長于β2微球蛋白≥5.5mg/L患者組(76個月VS 37個月,P=0.004);(3)非重度貧血患者組OS顯著長于重度貧血患者組(61個月VS 28個月,P=0.017);(4)DS分組中A組患者組OS顯著長于B組患者組(61個月VS 17個月,P=0.001)。3、基于硼替佐米化療方案治療MM的的不良反應(yīng):(1)全組患者接受基于硼替佐米化療方案化療后不良反應(yīng)發(fā)生率為70.6%;(2)全組患者主要不良反應(yīng)包括白細胞減少、乏力、周圍神經(jīng)炎及感染,其發(fā)生率分別為23.5%,19.6%,17.6%及15.7%。結(jié)論:1、基于硼替佐米化療方案治療MM具有良好療效;2、化療后未取得VGPR、β2微球蛋白增高、重度貧血、腎功能損害的患者預(yù)后差;3、基于硼替佐米化療方案治療MM安全性好。
[Abstract]:Objective: to evaluate the efficacy and safety of bortezomib chemotherapy in the treatment of multiple myeloma (MM). Methods: the clinical data of 51 newly treated MM patients who were admitted to the first affiliated Hospital of Guangxi Medical University from November 2009 to November 2016 were analyzed retrospectively. Kaplan-Meier method was used for survival analysis and Log-Rank test was used to determine the related factors affecting prognosis. Results: (1) 51 patients with MM received 4 cycles of chemotherapy. The complete remission rate (CR) and total response rate (OR) were 23.5% and 86.3%, respectively; (2) the 3-year survival rate was 68.7% and the 5-year survival rate was 31.1%; (3) the median total survival time (overall survival OS) and the median disease-free progressive survival period (progression) in this group were 68.7% and 31.1% respectively; (3) the median survival time (progression) and the median survival time (progression) of the patients were 23.5% and 86.3%, respectively; (2) the 3-year survival rate was 68.7% and the 5-year survival rate was 31.1%, respectively. The free survival rate was 61 months and 32 months, respectively. The factors related to the efficacy of bortezomib regimen in the treatment of MM were as follows: (1) the patients with CR and very good partial remission (very good partial remissions) were significantly longer than those with no bortezomil (40 patients). The OS of serum 尾 2 microglobulin 5.5 mg / L group was significantly longer than that of 尾 2 microglobulin 鈮，

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