DICE方案治疗难治或复发性非霍奇金淋巴瘤的临床观察  

Efficacy of DICE regimen on relapsed and refractory non-hodgkin's lymphoma

作　　者：李海金[1] 董良[1] 李英[1] 符淑媛[1] 

机构地区：[1]中国医科大学绍兴医院肿瘤内科,浙江绍兴312030

出　　处：《中华肿瘤防治杂志》2009年第8期629-632,共4页Chinese Journal of Cancer Prevention and Treatment

摘　　要：目的:观察DICE方案治疗难治或复发性非霍奇金淋巴瘤的疗效和不良反应。方法:42例难治或复发性非霍奇金淋巴瘤患者均采用DICE方案进行解救化疗,地塞米松20mg/d、异环磷酰胺1200mg/(m2.d)、顺铂25mg/(m2.d)以及依托泊苷80mg/(m2.d),均是加入生理盐水中静脉滴入,d1～d4,21d为1个周期,观察疗效、KPS评分变化、生存期及不良反应。结果:42例患者均完成>6个周期的DICE方案化疗,总有效率为61.90%,完全缓解率33.33%,部分缓解率28.57%。T、B细胞患者总有效率分别为64.29%和57.14%,P=0.65;难治、复发患者总有效率分别为63.16%和60.87%,P=0.88;伴LDH增高、LDH正常患者总有效率分别为53.57%和78.57%,P=0.12。KPS评分改善率73.81%,中位生存期19个月(5～61个月),3年生存率35.71%。主要不良反应是恶心呕吐、骨髓抑制和脱发等,经治疗均恢复。结论:DICE方案是治疗难治或复发性非霍奇金淋巴瘤安全有效的解救方案。OBJECTIVE： To evaluate the efficacy and adverse events of DICE（（Dexamethasone, Etoposide, Ifosfamide, and Cisplatin） regimen on relapsed or refractory non-hodgkin＇s lymphoma （NHL）. METHODS： A total of 42 patients with relapsed or refractory non hodgkin＇s lymphoma accepted DICE regimen for 6 cycles. DICE regimen： dexamethasone 20 mg/d, ifosfamide 1 200 mg/（m^2· d）, eisplatin 25 mg/（m^2·d）, etoposide 80 mg/（m^2·d）, d1 -d4 , 21 d as a cycle. The efficacy, the changes of KPS score, survival time, and adverse events were evaluated. RESULTS： The total response rate （RR） of all 42 patients was 61. 90%, The complete remission （CR） rate was 33.33%. The partial remission rate was 28.57%. The total response rate was 64.29% for T-cell NHL, and 57.14% for B-cell NHL（P=0.65）. The total response rate was 63. 16% for refractory NHL, and 60.87% for relapsed NHL（P=0. 88）. The total response rate was 53. 570/00 for evaluated LDH NHL, and 78.57% for normal LDH NHL（P=0. 12）. The improving rate of KPS was 73. 81%. The median survival time was 19 months （range from 5 months to 61 months）, the survival rate at 3 year was 35.71%. the major adverse events were nausea/vomit, myelosuppression, and alopecia. There was no treament associated death. CONCLUSION： DICE regimen is a safe and effective salvage regimen for the patients with relapsed and refractory NHL.

关 键 词：淋巴瘤 非霍奇金/药物疗法 药物疗法 联合 疗效结果 复发 

分 类 号：R733.1[医药卫生—肿瘤]