张会来, 王华庆, 付凯, 侯芸, 李维, 周世勇, 邱立华, 钱正子, 刘贤明. R-GemOx与RICE方案二线治疗复发或难治性弥漫大B细胞淋巴瘤的临床对比研究[J]. 中国肿瘤临床, 2011, 38(18): 1107-1110. DOI: 10.3969/j.issn.1000-8179.2011.18.013
引用本文: 张会来, 王华庆, 付凯, 侯芸, 李维, 周世勇, 邱立华, 钱正子, 刘贤明. R-GemOx与RICE方案二线治疗复发或难治性弥漫大B细胞淋巴瘤的临床对比研究[J]. 中国肿瘤临床, 2011, 38(18): 1107-1110. DOI: 10.3969/j.issn.1000-8179.2011.18.013
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Huilai ZHANG, Huaqing WANG, Kai FU, Yun HOU, Wei LI, Shiyong ZHOU, Lihua QIU, Zhengzi QIAN, Xianming LIU. Comparative Study of R-GemOx and RICE Regimens as Second-line Treatments for Refractory or Relapsed DLBCL[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2011, 38(18): 1107-1110. DOI: 10.3969/j.issn.1000-8179.2011.18.013
Citation: Huilai ZHANG, Huaqing WANG, Kai FU, Yun HOU, Wei LI, Shiyong ZHOU, Lihua QIU, Zhengzi QIAN, Xianming LIU. Comparative Study of R-GemOx and RICE Regimens as Second-line Treatments for Refractory or Relapsed DLBCL[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2011, 38(18): 1107-1110. DOI: 10.3969/j.issn.1000-8179.2011.18.013
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R-GemOx与RICE方案二线治疗复发或难治性弥漫大B细胞淋巴瘤的临床对比研究

Comparative Study of R-GemOx and RICE Regimens as Second-line Treatments for Refractory or Relapsed DLBCL

    摘要
  • 摘要: 对比美罗华联合奥沙利铂和吉西他滨（R-GemOx）与RICE方案二线治疗复发或难治性的弥漫大B细胞淋巴瘤（DLBCL）的疗效及毒副作用。方法：选取复发或难治性弥漫大B细胞淋巴瘤患者65例，随机分为两组，分别接受R-GemOx方案和RICE方案化疗。R-GemOx组方案为：美罗华，375 mg/m2静脉滴注，d0，吉西他滨（GEM）1 000 mg/m2，静脉滴注，d1、8；奥沙利铂（L-OHP）130 mg/m2，静脉滴注，d1；21天为1周期。RICE组方案为：美罗华，375 mg/m2，静脉滴注，d0；异环磷酰胺（IFO ）1 g/m2，静脉滴注，d1～d3；Mesna解救400mg，静脉滴注q8h，d1～d3；卡铂（CBP），AUC=5，静脉滴注，d2；依托泊苷（VP-16 ）100mg/m2，静脉滴注，d1～d3。21天为1个周期。每2周期进行疗效及毒性评价。结果：65例患者中，R-GemOx方案组，完全缓解（CR）4例（12.5%），部分缓解（PR）17例（53.1%），稳定（SD）6例，进展（PD）5例，总有效率（CR+PR）为65.6%，临床获益率（CR+PR+SD）达到84.4%。RICE组CR 4例（12.1%），PR 16例（48.5%），SD 7例，PD 6例，总有效率60.6%，临床获益率81.8%。两组的不良反应主要为骨髓抑制，其中R-GemOx组白细胞下降Ⅲ度5例，Ⅳ度2例；贫血Ⅲ度2例；血小板下降Ⅲ度4例，Ⅳ度2例。RICE组白细胞下降Ⅲ度16例，Ⅳ度5例；贫血Ⅲ度2例；血小板下降Ⅲ度5例，Ⅳ度3例。胃肠道反应RICE组较R-GemOx组为重，其中Ⅲ度2例，Ⅳ度1例。比较两组毒副反应，R-GemOx组在中性粒细胞减少，消化道反应方面明显好于RICE组（P<0.05）。而RICE组未出现一例末梢神经毒性。结论：R-GemOx方案是二线治疗复发或难治性弥漫大B细胞淋巴瘤较为安全且有效的化疗方案，其远期疗效尚需进一步观察。

     

    Abstract: o compare the efficacy and safety of R-GemOx and RICE regimens for treating relapsed or refractory non-Hodgkin's lymphoma (NHL). Methods: Up to 65 cases with relapsed and refractory diffuse large B cell lymphoma (DLBCL) were randomly divided into two groups. These patients received R-GemOx and RICE regime, respectively. The R-GemOx regimen included rituximab at 375 mg/m2, ivd, d0; GEM at 1000 mg/m2, ivd, d1, 8; and L-OHP at 130 mg/m2, ivd, d1 at 21 days per cycle. The RICE regime included rituximad at 375 mg/m2, ivd, d0; IFO at 1 g/m2, ivd, d1-d3; Mesna at 400 mg, ivd q8h, d1-d3; CBP AUC = 5, ivd, d2; and Vp-16 at 100 mg/m2, ivd, d1-d3 at 21 days per cycle. Their efficacy and safety were evaluated every two weeks. Results: For the R-GemOx group, complete remission ( CR ) was achieved in 4 cases ( 12.5% ), partial remission ( PR ) in 17 cases ( 53.1% ), stable disease ( SD ) in 6 cases, and progressive disease ( PD ) in 5 cases. The overall response rate ( CR+PR ) was 65.6%, and the clinical benefit rate ( CR+PR+ SD ) was 84.4%. For the RICE group, CR was achieved in 4 cases ( 12.1% ), PR in 16 cases ( 48.5% ), SD in 7 cases, and PD in 6 cases. The overall response rate ( CR+PR ) was 60.6%, and the clinical benefit rate ( CR+PR+ SD ) was 81.8%. The main side effect was bone marrow suppression. In the R-GemOx group, leukopenia was observed with 5 cases at grade Ⅲand 2 cases at grade Ⅳ; anemia was observed with 2 cases at grade Ⅲ; thrombocytopenia was observed with 5 cases at grade Ⅲ and 3 cases at grade Ⅳ. In the RICE group, leukopenia was observed with 16 cases at grade Ⅲ and 5 cases at grade Ⅳ; anemia was observed with 2 cases at grade Ⅲ; thrombocytopenia was observed with 5 cases at grade Ⅲ and 3 cases at grade Ⅳ. The gastrointestinal tract reaction in the RICE group was more serious than in the R-GemOx group: 2 cases at grade Ⅲ and 1 case at grade Ⅳ. Comparison of the side effects in the two groups revealed that R-GemOx was better for neutrocytopenia and gastrointestinal tract reaction than RICE ( P < 0.05 ). Conclusion: R-GemOx is a safer and more effective regimen for treating relapsed or refractory DLBCL, and its efficacy requires observation and research.

     

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