PTD方案與TD方案治療多發性骨髓瘤療效的隨機對照試驗_《中國循證醫學雜志》

作者：

 馬春蓉 , 曹紅 , 李林 , 劉雅倩

南充市中心醫院血液科（四川南充?637000）;

關鍵詞：

多發性骨髓瘤骨痛帕米膦酸二鈉沙利度胺聯合治療隨機對照試驗

DOI：

10.7507/1672-2531.20090145

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目的　比較PTD（帕米膦酸二鈉+沙利度胺+地塞米松）方案與TD（沙利度胺+地塞米松）方案治療多發性骨髓瘤的臨床療效。
方法　在2004年1月～2008年12月間，將符合納入標準的患者按就診順序隨機分配到PTD方案組和TD方案組，治療8周后觀察其療效和不良反應。統計分析使用SPSS 13.0軟件。
結果　共納入25例患者，其中PTD方案組13例， TD方案組12例。結果顯示，PTD方案與TD方案的總有效率分別為84.6%和83.3%，差異無統計學意義（P gt;0.05）；在骨痛改善方面，PTD組顯效率（5/13 vs 1/12）及短期起效率（4/13 vs 1/12）優于TD組，差異有統計學意義（P lt;0.05）。
結論　PTD方案較TD方案對骨痛的緩解程度更強、起效更快；在總有效率方面，尚需增大樣本量進一步研究。

引用本文： 馬春蓉,曹紅,李林,劉雅倩. PTD方案與TD方案治療多發性骨髓瘤療效的隨機對照試驗. 中國循證醫學雜志, 2009, 09(8): 824-827. doi: 10.7507/1672-2531.20090145 復制

1.	張之南. 血液病診斷及療效標準. 第2版. 北京: 科技出版社, 1999. 373-379.
2.	Singhal S, Mehta J, Desikan R, et al. Antitumor activity of thalidomide in refractory multiple myeloma. N Engl J Med, 1999, 341(21): 1565-1571.
3.	Yeh HS, Berenson JR. Treatment for myeloma bone disease. Clin Cancer Res, 2006, 12(20P12): 6279-6284.
4.	Rajkumar SV, Gertz MA Lacy MQ, et al. Thalidomide as initial therapy For early stage myeloma. Leukemia, 2003, 10: 375-379.
5.	Marriott JB, Muller G, Stirling D, et al. Immunotherapeutic and antitumour potential of thalidomide analogues. Expert Opin Biol Ther, 2001, 1(4): 675-682.
6.	Hideskima T. Thalidomide and its analogues overcome drug resistance of human multiple myeloma cells to conventional therapy. Blood, 2000, 96(9): 2943-2950.
7.	Weber D. Thalidomide alone or with dexamethasone for previously untreated multiple myeloma. J Clin Oncol, 2003, 21(1): 16-19.
8.	Kanis IA, Meclosekey EV. Bisphosphonate in multiple myeloma. Cancer, 2000, 88(S12): 3022-3032.
9.	王丹, 高楠. 帕米膦酸二鈉治療多發性骨髓瘤骨痛的臨床觀察. 用藥觀察, 2005, 5(3): 168-169.
10.	Raje N, Anderson KC. Introduction: the evolving role of bisphosphonate therapy in multiple myeloma. Blood, 2000, 96:381-384.
11.	Kuzzmann V, Bauer E, Fouria J, et al. Stimulation of gammadelta T cells by aminobisphosphonate and induction of antiplasma cell activity in multiple myeloma. Blood, 2000, 96: 384-392.
12.	Derenne S, Amiot M, Barille S, et al. Zoledronate is a potent inhibitor of myeloma cell growth and secretion of IL-6 and MMP-1 by the tumoral environment. J Bone Miner Res, 1999, 14: 2048-2056.
13.	Dhodapkar MV, Singh J, Mehta J, et al. Anti-myeloma activity of pamidronate in vivo. Br J Haematol, 1998, 103: 530-532.
14.	Tassone P, Foreinitis, Galea E, et al. Growth inhibition and synergistic induction of apoptosis by bisphosphonate and dexamethasone in human myeloma cell lines. Leukemia, 2000, 14: 841-844.

1. 張之南. 血液病診斷及療效標準. 第2版. 北京: 科技出版社, 1999. 373-379.
2. Singhal S, Mehta J, Desikan R, et al. Antitumor activity of thalidomide in refractory multiple myeloma. N Engl J Med, 1999, 341(21): 1565-1571.
3. Yeh HS, Berenson JR. Treatment for myeloma bone disease. Clin Cancer Res, 2006, 12(20P12): 6279-6284.
4. Rajkumar SV, Gertz MA Lacy MQ, et al. Thalidomide as initial therapy For early stage myeloma. Leukemia, 2003, 10: 375-379.
5. Marriott JB, Muller G, Stirling D, et al. Immunotherapeutic and antitumour potential of thalidomide analogues. Expert Opin Biol Ther, 2001, 1(4): 675-682.
6. Hideskima T. Thalidomide and its analogues overcome drug resistance of human multiple myeloma cells to conventional therapy. Blood, 2000, 96(9): 2943-2950.
7. Weber D. Thalidomide alone or with dexamethasone for previously untreated multiple myeloma. J Clin Oncol, 2003, 21(1): 16-19.
8. Kanis IA, Meclosekey EV. Bisphosphonate in multiple myeloma. Cancer, 2000, 88(S12): 3022-3032.
9. 王丹, 高楠. 帕米膦酸二鈉治療多發性骨髓瘤骨痛的臨床觀察. 用藥觀察, 2005, 5(3): 168-169.
10. Raje N, Anderson KC. Introduction: the evolving role of bisphosphonate therapy in multiple myeloma. Blood, 2000, 96:381-384.
11. Kuzzmann V, Bauer E, Fouria J, et al. Stimulation of gammadelta T cells by aminobisphosphonate and induction of antiplasma cell activity in multiple myeloma. Blood, 2000, 96: 384-392.
12. Derenne S, Amiot M, Barille S, et al. Zoledronate is a potent inhibitor of myeloma cell growth and secretion of IL-6 and MMP-1 by the tumoral environment. J Bone Miner Res, 1999, 14: 2048-2056.
13. Dhodapkar MV, Singh J, Mehta J, et al. Anti-myeloma activity of pamidronate in vivo. Br J Haematol, 1998, 103: 530-532.
14. Tassone P, Foreinitis, Galea E, et al. Growth inhibition and synergistic induction of apoptosis by bisphosphonate and dexamethasone in human myeloma cell lines. Leukemia, 2000, 14: 841-844.

《中國循證醫學雜志》

PTD方案與TD方案治療多發性骨髓瘤療效的隨機對照試驗

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《中國循證醫學雜志》

PTD方案與TD方案治療多發性骨髓瘤療效的隨機對照試驗

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