DNCE regimen for treatment of refractory or relapsed aggressive and highly aggressive non-Hodgkin lymphoma.
- Author:
Xian-ming LIU
1
;
Hua-qing WANG
;
Hui-lai ZHANG
;
Li-hua QIU
;
Wei LI
;
Lan-fang LI
;
Xiu-zhen CUI
;
Peng-fei LIU
;
Xi-shan HAO
Author Information
- Publication Type:Journal Article
- MeSH: Adolescent; Adult; Aged; Antineoplastic Agents, Phytogenic; administration & dosage; adverse effects; Antineoplastic Combined Chemotherapy Protocols; adverse effects; therapeutic use; Cisplatin; administration & dosage; adverse effects; therapeutic use; Dexamethasone; administration & dosage; adverse effects; therapeutic use; Etoposide; administration & dosage; adverse effects; therapeutic use; Female; Humans; Ifosfamide; adverse effects; therapeutic use; Leukopenia; chemically induced; Lymphoma, Non-Hodgkin; drug therapy; pathology; Male; Middle Aged; Nausea; chemically induced; Neoplasm Recurrence, Local; Neoplasm Staging; Remission Induction; Salvage Therapy; Survival Rate; Thrombocytopenia; chemically induced; Vinblastine; administration & dosage; adverse effects; analogs & derivatives; Young Adult
- From: Chinese Journal of Oncology 2008;30(10):779-782
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVETo evaluate the efficacy and safety of DNCE [DXM, navelbine (NVB), DDP and Vp-16] regimen and DICE [dexamethasone (DXM), ifosfamide (IFO), cisplatin (DDP) and etoposide (Vp-16)] regimen in the treatment of refractory or relapsed aggressive and highly aggressive non-Hodgkin lymphoma (NHL).
METHODSA total of 69 patients with histopathologically proved advanced aggressive and highly aggressive NHL were randomized into trial group (32 patients treated with DNCE regimen) and control group (37 patients treated with DICE regimen). The control group was given DICE regimen: DXM 20 mg, iv d1 approximately d4; IFO 1 g/m2), iv d1 approximately d4; Mesna 400 mg, iv q8h, d1 approximately d4; DDP 25 mg/m2, iv d1 approximately d4; Vp-16 100 mg/m2, iv d1 approximately d4; one cycle for 21 approximately 28 days. The trial group was given DNCE regimen: DXM 20 mg, iv d1 approximately d4; NVB 25 mg/m2, iv d1 and d5; DDP 25 mg/m2, iv d1 approximately d4; Vp-16 100 mg/m2, iv d1 approximately d4; one cycle for 21 approximately 28 days. Each patient completed at least 2 cycles of treatment.
RESULTSA better efficacy was shown in the complete response rate, partial response rate, and total response rate between DNCE and DICE groups (18.8% vs. 10.8%, 37.5% vs. 35.1%, and 56.3% vs. 45.9%, respectively), but the differences were statistically non-significant (P > 0.05). The 1-, 3-, and 5-year survival rates were not significantly increased in DNCE group compared with that in DICE group (86.5% vs. 87.5%, 58.3% vs. 63.2%, 42.9% vs.38.5%, respectively, P > 0.05). The major side effects were leucopenia, thrombocytopenia, and nausea in both groups. The bone marrow depression in DNCE group was significantly slighter than that in the DICE group (P < 0.05).
CONCLUSIONThe efficacy of DNCE regimen is as good as DICE regimen, and the bone marrow toxicity is less severe in DNCE group than that in DICE regimen. Therefore, the DNCE regimen is an effective second-line salvage regimen for the treatment of refractory or relapsed aggressive and highly aggressive non-Hodgkin lymphoma.
