Abstract: ［Abstract］ Objective To investigate the efficacy and toxicities of thalidomide （oral， starting dose 100 mg/d， increase 50 mg per week， up to 200 mg/d， QN， maintain） combined with R?GEMOX regimen （rituximab 375 mg/m2 d0， gemcitabine 1000 mg/m2， d1， d8， oxaliplatin 130 mg/m2 d1） in treatment of relapsed/refractor B?cell Non?Hodgkin′s lymphoma （NHL）. Methods Thirty?six patients with relapsed or refractor B?cell NHL after medication of traditional chemotherapy accepted thalidomide combined with R?GEMOX regimen，the efficacy toxicities was evaluated after two cycles of chemotherapy， the toxicities was evaluated after 1 cycles of chemotherapy. Results Of the 36 cases， 14 patients were in complete remission and 15 in partial remission， resulting in an overall response rate of 80%. Thirteen patients symptom disappeared， and one in 15 cases was alleviated of type B symptoms. The toxicities can be tolerated. Conclusion Thalidomide combined with R?GEMOX regimen was effect for recurrent or refractory B?cell NHL， and the toxicity was mild. This protocol was worthy of clinical application as salvage for relapsed or refractory B?cell NHL.

Key words: thalidomide, oxaliplatin, non?Hodgkin′s lymphoma, rituximab, gemcitabine

摘要： ［摘要］ 目的 观察沙利度胺联合R?GEMOX方案（利妥昔单抗联合吉西他滨、奥沙利铂）挽救性治疗复发、难治B细胞性非霍奇金淋巴瘤（NHL）的疗效和毒副反应。方法 回顾性分析36例经正规标准方案治疗复发或难治的B细胞性NHL患者，采用沙利度胺（口服，100 mg/d起始，每周递增50 mg，直至200 mg/d，QN，维持）联合R?GEMOX方案（利妥昔单抗375 mg/m2，第0天；吉西他滨1000 mg/m2，第1、8天；奥沙利铂130 mg/m2，第1天），21～28 d为一个周期，每2个疗程后评价疗效，每1个疗程评价毒副反应。结果 36例患者中，14例完全缓解（CR），15例部分缓解（PR），总有效率（CR+PR）为80%。15例具有B类症状的患者，13例症状消失，1例明显改善。毒副反应可耐受。结论 沙利度胺联合R?GEMOX方案对复发难治B细胞性NHL疗效较好，毒副反应小，是一个良好的补救性化疗方案。

关键词: 吉西他滨, 非霍奇金淋巴瘤, 沙利度胺, 利妥昔单抗, 奥沙利铂