Objective: 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) . Methods: 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. Results: 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 (P=0.041, P=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 (P=0.050) . Medial overall survival was not achieved in both two groups, without statistically significant difference (P=0.257) . There were statistical differences between patients with minor response (MR) and patients without MR in medium OS in CTD group (P=0.005) , and there were statistical difference between patients with VGPR and without VGPR in medium OS in CTD group (P=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. Conclusion: 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.
目的： 分析比较CTD方案（环磷酰胺+沙利度胺+地塞米松）与PCD方案（硼替佐米+环磷酰胺+地塞米松）治疗新诊断多发性骨髓瘤（NDMM）患者的疗效、预后及安全性。 方法： 回顾性分析2013年7月至2016年1月收治的88例NDMM患者的临床资料，其中CTD方案组49例，PCD方案组39例，比较两组患者的疗效、预后以及不良反应。 结果： CTD与PCD组患者治疗后的总缓解率（ORR，≥部分缓解）分别为65.3%（32/49）和84.6%（33/39），非常好的部分缓解（VGPR）及以上疗效分别为30.6%（15/49）和53.8%（21/39），差异均有统计学意义（P值分别为0.041、0.028）。中位随访11.5（3~33）个月，CTD组与PCD组患者的无进展生存（PFS）时间差异有统计学意义[（23.0±4.5）个月对未达到，P=0.050]；中位总生存（OS）时间均未达到，差异无统计学意义（P=0.257）。CTD组获得≥微小缓解（MR）与未达MR患者的中位OS时间差异有统计学意义（未达到对12.3个月，P=0.005）；PCD组获得≥VGPR与未达VGPR患者的中位OS时间差异有统计学意义（未达到对29.0个月，P=0.042）。感染是两组患者最常见的不良反应，PCD组患者周围神经病变、带状疱疹发生率明显高于CTD组，而CTD组患者血栓、心慌、皮疹等发生率偏高。 结论： CTD与PCD方案均为治疗NDMM患者有较好疗效的一线诱导化疗方案；PCD方案治疗强度和缓解深度优于CTD方案。.
Keywords: Antineoplastic combined chemotherapy protocols; Drug toxicity; Multiple myeloma; Treatment outcome.