Analysis Of The Efficacy Of PAD And VAD Regimens In The Treatment Of Multip

Objective:To retrospectively analyze the clinical efficacy and adverse reactions of PAD and VAD regimens in the treatment of multiple myeloma,and to provide reference for the clinical application of bortezomib in hospitals and the development of related policies for medical insurance.Methods:We retrospectively analyzed the data of 52 patients with multiple myeloma admitted to our department of hematology from January 2012 to December 2017.According to the treatment plan,it is divided into PAD group?bortezomib+doxorubicin+dexamethasone?or VAD group?vincristine+doxorubicin+dexamethasone?.All patients were treated for more than 4 cycles.The efficacy was judged according to the International Myeloma Working Group?IMWG?efficacy criteria,and the adverse reaction judgement was based on the International Nosocomial Organization's Unified Nomenclature of Toxicological Effects?NCICTCAE?.The data of 52 patients were collected,including gender,age,blood routine,electrolytes,liver and kidney function,myeloma plasma cells,immunoglobulin quantification,immunofixation electrophoresis,plasma protein electrophoresis,and?microglobulin??₂-microglobulin,?₂-MG?,urinary light chain, urinary Zhous protein,bone X-ray examination,etc.,the above indicators were statistically analyzed.Measurement data are expressed as mean±standard deviation?x±s?.Count data are compared using the?² test.Measurement data using t test,and rank-sum data were compared using rank sum test.P<0.05 was statistically significant.Results:1.The curative effect of the two groups was compared:15 cases in PAD group,13 cases?86.66%?effective,and 2 cases?13.33%?invalid;37 cases in VAD group,24 cases?64.86%?effective,and 13 cases?35.14%?invalid;The efficiency of PAD group was higher than that of VAD group,and the difference was statistically significant?P<0.05?.Among them,PAD group had complete remission?CR?in 5 cases?33.33%?,very good partial remission?VGPR?in 6 cases?40.0%?,and partial remission?PR?in 2 cases?13.33%?.In the VAD group,there was complete remission?CR?in one case?2.7%?,very good partial remission?VGPR?in 10 cases?27.03%?,and partial remission?PR?in 13cases?35.13%?.2.The incidence of adverse reactions in the two groups during chemotherapy:There was no statistically significant difference in the probability of hematologic toxicity,gastrointestinal reactions,peripheral neuropathy,or adverse reactions between the two groups.Adverse reactions occurred in 6 patients?40.00%?in PAD group,including 4 cases in grades 1-2and 2 cases in grades 3-4;19 cases?51.35%?in VAD group,of which grade 1-2 In 12 cases,3-4 cases and 7 cases,the statistical analysis showed that the incidence of adverse reactions in the two groups was not statistically significant?P>0.05?.Adverse reactions can be tolerated and can be improved after symptomatic and supportive treatment such as whitening,platelet transfusion,nutrition of nerves,protection of gastric mucosa,anti-infection,liver protection,etc.Conclusion:1.The overall efficacy of the PAD regimen was significantly better than that of the VAD regimen.The former CR+VGPR was significantly higher than the latter?73.3%and29.7%?.2.Compared with the PAD regimen and the VAD regimen,there was no significant difference in the incidence of adverse reactions between the two groups;Adverse reactions were tolerable and could be improved after symptomatic treatment.