DICE方案治疗难治和复发性非霍奇金淋巴瘤的疗效分析

背景与目的:目前对于难治性和复发性非霍奇金淋巴瘤(non-Hodgkin)slymphoma,NHL)尚无标准解救化疗方案,本文旨在探讨DICE方案(地塞米松,异环磷酰胺,顺铂及VP-16)治疗难治和复发性NHL的疗效和不良反应。方法:80例难治和复发性NHL患者,其中T细胞NHL25例,B细胞NHL55例,既往均接受过6个周期的CHOP化疗方案无缓解。现采用DICE方案对患者进行解救治疗,并对毒副反应加以评估、预防及治疗。结果:80例患者接受6个周期DICE方案化疗后,总体有效率为56.3%,完全缓解率为27.5%;T、B细胞NHL有效率分别为48.0%、60.0%,完全缓解率为16.0%、32.7%(P>0.05);经DICE方案治疗的患者出现骨髓抑制、消化系统反应、脱发以及电解质紊乱发生率增高,经过治疗均恢复,无治疗相关死亡。结论:DICE方案治疗难治和复发性NHL有效。

Efficacy of DICE (dexamethasone, etoposide, ifosfamide, and cisplatin) regimen on recurrent and refractory non-Hodgkin's lymphoma

BACKGROUND & OBJECTIVE: There is no standard salvage regimen for patients with recurrent and refractory non-Hodgkin's lymphoma (NHL) so far. This study was to investigate the efficacy of DICE (dexamethasone, isofosfamide, cisplatin, and etoposide) regimen on recurrent and refractory NHL, and observe the adverse events. METHODS: Clinical records of 80 patients with recurrent and refractory NHL, who failed to get remission from CHOP regimen (cyclophosfamide, vincristine, and donaurubicin) and accepted DICE as a salvage regimen for 6 cycles, were reviewed. Of the 80 patients, 25 were T-cell original, and the other 55 were B-cell original. The efficacy of DICE regimen and adverse events were evaluated. RESULTS: The total response rate (RR) of these 80 patients was 56.3%. The complete remission (CR) rate was 27.5%.The total response rate was 48.0% for T-cell NHL and 60.0% for B-cell NHL. The CR rate was 16.0% for T-cell NHL and 32.7% for B-cell NHL. Myelosuppression, nausea, vomit, alopecia, and electrolytes disorder were major adverse events, and could be cured after treatment. No chemotherapy-related death occurred. CONCLUSION: DICE regimen is effective in treating recurrent and refractory NHL.