摘要
目的：观察环磷酰胺、强的松联合放疗方案治疗广泛性Kimura病的有效性及安全性。方法：32例广泛淋巴结肿大的Kimura病确诊患者,环磷酰胺片50 mg/d、强的松片60 mg/d,口服,d1~14,3周重复。肿块完全消失后巩固1周期,然后强的松减量维持3个月。药物治疗开始后两周由患者选择是否病灶处放疗,剂量24~36 Gy。结果：31例完成预定治疗方案,1例放疗结束后失访,均可判断近期疗效。药物组治疗完全缓解率为66.7%（6/9例）,放疗组为87.0%（20/23例）。药物组治疗复发率为44.4%（4/9例）,放疗组为18.2%（4/22例）。90.6%（29/32）治疗前外周血嗜酸性粒细胞显著升高,治疗后均显著下降,药物治疗两周后75.9%（22/29）恢复正常,到治疗结束93.1%（27/29例）恢复正常。血浆Ig E定量78.1%（25/32）升高,治疗后均有不同程度的降低,治疗两周后8.0%（2/25）的病例恢复正常;治疗结束64.0%（16/25）的病例恢复正常。骨髓抑制最为常见、轻微,仅12.5%（4/32）发生Ⅲ度中性粒细胞减少。其他毒性均为Ⅰ~Ⅱ度,耐受良好,无严重毒性事件发生。结论：环磷酰胺、强的松联合放疗治疗广泛性Kimura病疗效良好,安全可以耐受。
Objective：To evaluate the effect and safety of Cyclophosphamide and Predisone with or without radiotherapy in the treatment of Kimura’s disease. Method：32 patients with Kimura’s disease and with multiple lymph gland involved were treated with Cyclophosphamide（CTX,50 mg/d） and Prednisone（PRD,60 mg/d）.After the tumor completely disappeared,one more cycle was given for consolidation,Prednisone was reduced for 3 months.Two weeks after the start of the drug treatment,whether or not combination of radiotherapy was choosed by the patients（dose,24-36 Gy）.Result：31 cases completed the scheduled treatment.1 case lossed of follow-up after radiotherapy,but could evaluate the short-term response.The complete response rate of drug group was 66.7%（6/9）,the radiotherapy group was 87.0%（20/23）.The recurrence rate of drug group was 44.4%（4/9）,the radiotherapy group was 18.2%（4/22）.90.6%（29/32） patients’ peripheral blood eosinophils were significantly increased before treatment.After drug treatment,the peripheral blood eosinophils were all significantly decreased.Two weeks later,75.9%（22/29） were returned to normal.At the end of treatment,93.1%（27/29） were returned to normal.78.1%（25/32） patients with plasma Ig E increased before treatment.Two weeks after the treatment,8.0%（2/25） were returned to normal.At the end of treatment,64.0%（16/25） were returned to normal.The most common side effects were bone marrow suppression,only 12.5%（4/32） were grade Ⅲ neutropenia,the others were grade Ⅰ to Ⅱ, all were well tolerated and no severe toxicity occurred.Conclusion：These results support the finding that CTX＋PRD is an effective regimens for treatment Kimura’s disease with multiple radiotherapy,CTX＋PRD plus RT is associated with an excellent local control rate.
出处
《中外医学研究》
2016年第29期1-3,共3页
CHINESE AND FOREIGN MEDICAL RESEARCH
关键词
KIMURA病
环磷酰胺
强的松
放疗
Kimura’s disease
Cyclophosphamide
Prednisone
Radiotherapy
