DICE方案治疗复发或难治中高度恶性非霍奇金淋巴瘤的疗效分析  

Efficacy of the DICE(Dexamethasone,Isofosfamide,Cisplatin,and Etoposide) Regimen on Recurrent and Refractory Intermediate and High Grade Non-Hodgkin's Lymphoma

作　　者：杨磊[1] 宋诸臣[1] 徐小红[1] 魏金芝[1] 谭清和[1] 丛智荣[1] 彭春雷[1] 

机构地区：[1]南通大学附属肿瘤医院内科,江苏省南通市226361

出　　处：《中国肿瘤临床》2008年第20期1154-1157,共4页Chinese Journal of Clinical Oncology

基　　金：江苏省南通市科技计划项目资助(编号:2006-29)

摘　　要：目的:目前对于复发或难治中高度恶性非霍奇金淋巴瘤(non-Hodgkin's lymphoma,NHL)尚无标准解救化疗方案,本文旨在探讨DICE方案(地塞米松、异环磷酞胺、顺铂及VP-16)治疗复发或难治中高度恶性NHL的疗效和不良反应。方法:22例复发或难治中高度恶性NHL患者,既往均接受过2～6个周期的CHOP化疗方案无缓解或复发。现采用DICE方案化疗,中位疗程数4个周期(2～7个周期),所有患者均可评价疗效和不良反应。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:22例患者DICE方案化疗后,总有效率为63.6%,完全缓解率为40.9%;T、B细胞NHL有效率分别为75.0%、57.1%,完全缓解率分别为37.5%、42.9%(P>0.05);LDH升高、伴有巨大肿块是影响复发耐药患者近期疗效的高危因素(P均<0.05)。经DICE方案治疗的患者,骨髓抑制、消化系统反应、脱发是较常见的并发症,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。Objective： There is currently no standard salvage regimen for patients with recurrent and refractory non-Hodgkin＇s lymphoma （NHL）. This study investigated the efficacy of the DICE （dexamethasone, isofosfamide, cisplatin, and etoposide） regimen on recurrent and refractory NHL and observed the corresponding adverse events. Methods： We reviewed the clinical records of 22 patients with recurrent and refractory NHL who failed to achieve remission after 2-6 cycles of CHOP regimen and received DICE as a salvage regimen with a median of 4 cycles （range 2-7 cycles）. Of the 22 patients, 8 patients had malignancies originating from T-cells, and the other 14 had malignancies originating from B-cells. The efficacy of the DICE regimen and its adverse events were evaluated. Results： The total response rate （RR） of these 22 patients was 63.6%. The complete remission （CR） rate was 40.9%. The response rate was 75.0% for T-cell NHL and 57.1% for B-cell NHL. The CR rate was 37.5% for T-cell NHL and 42.9% for B-cell NHL （P〉0.05）. Elevated serum levels of lactate dehydrogenase （LDH） and the presence of bulky disease were risk factors for the efficacy Of the DICE regimen （P〈0.05）. Major adverse events included myelosuppression, nausea, vomiting, and alopecia, and these adverse effects could be treated. No chemotherapy-related death occurred. Conclusion： The DICE regimen is effective for treating recurrent and refractory NHL.

关 键 词：非霍奇金淋巴瘤 化疗 DICE方案 疗效 不良反应 

分 类 号：R733.1[医药卫生—肿瘤] R521[医药卫生—临床医学]