DACE方案治疗难治复发性非霍奇金淋巴瘤的临床疗效

Efficacy of DACE Regimen on Relapsed and Refractory Non-Hodgkin’s Lymphoma

背景与目的:难治复发性非霍奇金淋巴瘤二线解救方案甚多,目前国内外尚无标准的解救方案。本研究旨在观察DACE方案治疗难治复发性非霍奇金淋巴瘤的治疗疗效及毒副作用。方法:我院从2001年5月至2006年5月对61例难治复发性非霍奇金淋巴瘤患者,采用DACE方案进行化疗,具体为:顺铂20mg/m2,静脉滴注,第1～5天;足叶乙甙100mg,静脉滴注,第1～5天;阿糖胞苷150mg,静脉滴注,第1～3天;地塞米松15mg/m2,静脉滴注,第1～5天,3周为一疗程。按照WHO疗效评价标准及WHO对抗癌药物急性与亚急性反应的分度标准进行临床疗效及毒副作用评估。结果:两周期后有效率63.9%,4周期后有效率72.1%。有效患者中位缓解时间4.7个月(1～58个月),1年生存率29.5%,2年生存率21.3%。主要毒副作用为Ⅲ～Ⅳ度骨髓抑制49.1%,患者能够耐受。结论:DACE方案可作为难治复发性非霍奇金淋巴瘤的解救方案之一。

BACKGROUND ＆ OBJECTIVE： There is no standard salvage regimen for patients with relapsed and refractory non-Hodgkin＇s lymphoma （NHL） at present. This study was to evaluate the efficacy of DACE regimen, as a salvage regimen, on relapsed and refractory NHL, and observe the adverse events. METHODS： From May 2001 to May 2006, 61 patients with relapsed and refractory NHL received chemotherapy of DACE regimen： intravenous infusion of cisplatin （20 mg/m2） on Days 1-5, etoposide （100 mg） on Days 1-5, cytarabine （150 mg） on Days 1-3, and dexamethone （15 mg/m2） on Days 1-5; repeated every 3 weeks. The efficacy and adverse events were evaluated according to the World Health Organization criteria. RESULTS： The overall response rates were 63.9% after two cycles of chemotherapy and 72.1% after four cycles. The median remission time lasted 4.7 months （1-58 months）. The 1-year survival rate was 29.5%; the 2-year survival rate was 21.3%. Myelosuppression was the major adverse event： the occurrence rate of grade III -IV myelosuppression was 49.1%; it was well tolerated. CONCLUSION. DACE regimen is an effective salvage regimen in treating patients with relapsed and refractory NHL.