title: [Efficacy comparison between standard and reduced doses of bortezomib combined with adriamycin and dexamethasone in the treatment of patients with multiple myeloma].
abstract: OBJECTIVE
  To compare the efficacy and safety of standard or reduced doses of bortezomib combined with adriamycin and dexamethasone (PAD) in patients with multiple myeloma (MM).
  
  
  METHODS
  Eighty-two newly diagnosed or refractory/relapsed patients received bortezomib [either 1.2-1.3 mg/m(2) (standard dose) or 1.0-1.1 mg/m(2) (reduced dose) on day 1, 4, 8 and 11], and adriamycin (10 mg/m(2)) plus dexamethasone (40 mg/m(2)) on day 1-4 at 3-week intervals for 1 to 6 courses. The International Myeloma Working Group Criteria were used to evaluate the response. Adverse events were graded according to the National Cancer Institute Common Toxicity Criteria (Version 3.0).
  
  
  RESULTS
  Two courses of standard dose of PAD resulted in a similar response rate of partial and very good partial complete remissions (PR) compared with reduced dose (80.0% vs 80.8%, P=0.728). Grade III- Ⅳ neutropenia and thrombocytopenia were higher with standard dose than that with reduced doses of PAD (21.1% vs11.1%, P=0.270; 10.5% vs 6.3%, P=0.619, respectively). Grade III-Ⅳ bortezomib-induced peripheral neuropathy, herpes zoster, fatigue or abdominal distention were significantly higher with standard dose than that with reduced dose of PAD (15.8% vs 1.6%, P=0.037; 26.3% vs 6.3%, P=0.028; 36.8% vs 14.3%, P=0.046; 15.8% vs 1.6%, P=0.037, respectively).
  
  
  CONCLUSIONS
  Reduced dose of PAD appears to result in a similar overall response rate, but a better tolerance and safety compared with standard dose.
authors.affiliation: Department of Hematology, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, China.
authors.forename: Hong-tao
authors.initials: HT
authors.lastname: Gu
authors.forename: Mi-mi
authors.initials: MM
authors.lastname: Shu
authors.forename: Guang-xun
authors.initials: GX
authors.lastname: Gao
authors.forename: Bao-xia
authors.initials: BX
authors.lastname: Dong
authors.forename: Rong
authors.initials: R
authors.lastname: Liang
authors.forename: Lan
authors.initials: L
authors.lastname: Yang
authors.forename: Qing-xian
authors.initials: QX
authors.lastname: Bai
authors.forename: Tao
authors.initials: T
authors.lastname: Zhang
authors.forename: Yong-qing
authors.initials: YQ
authors.lastname: Zhang
authors.forename: Xie-qun
authors.initials: XQ
authors.lastname: Chen
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D001897:Boronic Acids / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D000069286:Bortezomib; D003907:Dexamethasone / Q000008:administration & dosage / Q000009:adverse effects; D004317:Doxorubicin / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000188:drug therapy*; D011719:Pyrazines / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D001897:Boronic Acids; D011719:Pyrazines; D000069286:Bortezomib; D003907:Dexamethasone; D004317:Doxorubicin