DICE方案治疗复发或耐药侵袭性淋巴瘤的临床研究  

DICE regimen for patients with relapsed or chemo-resistant invasive non-Hodgkin lymphoma

作　　者：谭琳[1] 曾云[1] 谢瑜[1] 杨坚[1] 

机构地区：[1]昆明医学院第一附属医院血液科,650032

出　　处：《白血病．淋巴瘤》2009年第1期32-34,共3页Journal of Leukemia & Lymphoma

摘　　要：目的观察DICE方案治疗复发或耐药侵袭性非霍奇金淋巴瘤（NHL）的疗效和患者的不良反应。方法50例复发或耐药侵袭性NHL患者均接受过至少1种化疗方案的治疗，中位方案数为2（1～4）种，中位疗程数6（2～12）个。DICE方案：异环磷酰胺（IFO）1．5g／m^2加入生理盐水100ml静脉滴注，第1天至第3天；巯乙磺酸钠（商品名：美斯钠）400mg加入生理盐水30ml，分别于IFO的同时及之后4h和8h静脉注射，第1天至第3天；顺铂（DDP）20mg／m^2静脉滴注，第1天至第4天；依托泊苷（VP16）50mg／m^2口服，第1天至第5天。地塞米松（DEX）20mg／m^2第1天至第7天，每3周为1个疗程：化疗2．6个疗程（中位疗程数4个）。结果50例患者均可评价疗效和不良反应，总有效率46．0％（23例），完全缓解率16．0％（8例）。B细胞来源淋巴瘤（26例）有效率53．84％，T细胞来源淋巴瘤（24例）有效率29．2％。全组1年生存率34．0％，2年生存率8．0％。主要不良反应为骨髓抑制，其中Ⅲ～Ⅳ度白细胞减少发生率为38．0％（19例），Ⅲ-Ⅳ度血小板减少发生率为14．0％（7例）；1例患者出现Ⅲ度肝功能损害。结论DICE方案为复发或耐药侵袭性NHL患者经济、有效的挽救治疗方案，不良反应可以耐受，但缓解时间较短，值得进一步研究应用。Objective To evaluate the efficacy of DICE regimen on relapsed or refractory NHL, and observe its toxicity. Methods Records of 50 patients with relapsed or refractory invasive NHL were treated with DICE regimen. All patients had received at least 1 type of chemotherapy regimen with a median of 6 cycles. The patients received a median of 4 cycles of DICE regimen. Results The treatment outcome and adverse events of all patients were analyzed. The overall response rate was 48.0 %, with a complete response （CR） rate of 16.0 %, The response rates were 53.8 % in the 26 patients with B-cell lymphoma and 29.2 % in the 24 patients with T-cell lymphoma. The 1- and 2-year survival rates were 34.0 % and 8.0 %, respectively. The major adverse event was myelosuppression： the prevalence of grade Ⅲ～Ⅳ neutropenia was 38.0 %, and that of grade Ⅲ～Ⅳ was 14.0 %. One patient suffered grade m liver toxicity. Conclusion DICE regimen was effective for patients with relapsed or refractory invasive NHL, and its toxicity is well tolerated, but the response term is relatively short. Further clinical study on the application of DICE regimen is needed.

关 键 词：淋巴瘤 非霍奇金 药物疗法 联合 抗肿瘤联合化疗方案 

分 类 号：R733.1[医药卫生—肿瘤] R521[医药卫生—临床医学]