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目的观察硼替佐米在治疗多发性骨髓瘤中的临床疗效及其不良反应。方法选择我院2004年2月至2011年5月住院治疗的62例多发性骨髓瘤患者,按治疗方案不同分为2组。治疗组(n=38)采用硼替佐米加大剂量地塞米松治疗6疗程;对照组(n=24)采用VAD方案(长春新碱、阿霉素及地塞米松)治疗6疗程。结果治疗组和对照组完全缓解率(CR)分别为39.4%和20.8%,总有效率(TERs)分别为81.6%和58.3%;不良反应中周围神经病变发生率分别为34.2%和37.5%,血小板减少发生率分别为28.9%和20.8%,感染发生率分别为10.5%和8.3%;死亡发生率分别为2.6%(1/38)和0%。两组TERs比较,差异有统计学意义(P<0.05);但2组不良反应(包括周围神经病变、血小板减少和感染)发生率比较差异无统计学意义(P>0.05)。结论硼替佐米治疗多发性骨髓瘤的疗效确切。
Objective To observe the clinical efficacy and adverse reactions of bortezomib in the treatment of multiple myeloma. Methods Sixty-two patients with multiple myeloma who were hospitalized from February 2004 to May 2011 in our hospital were divided into two groups according to the different treatment options. The treatment group (n = 38) received high doses of dexamethasone bortezomib 6 courses of treatment; the control group (n = 24) VAD regimens (vincristine, doxorubicin and dexamethasone) for 6 courses of treatment. Results The complete response rate (CR) of the treatment group and the control group were 39.4% and 20.8%, respectively, and the total effective rates (TERs) were 81.6% and 58.3% respectively. The incidences of peripheral neuropathy in the adverse reactions were 34.2% and 37.5% The incidences of thrombocytopenia were 28.9% and 20.8% respectively, and the prevalences were 10.5% and 8.3% respectively. The incidence of death was 2.6% (1/38) and 0%, respectively. There was significant difference between the two groups of TERs (P <0.05). There was no significant difference in the incidence of adverse reactions (including peripheral neuropathy, thrombocytopenia and infection) between the two groups (P> 0.05). Conclusion Bortezomib is effective in treating multiple myeloma.