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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 observe the efficacy and adverse reactions of DICE regimen in the treatment of refractory or recurrent non-Hodgkin’s lymphoma. Methods: 42 patients with refractory or recurrent non-Hodgkin’s lymphoma were treated with DICE regimen, dexamethasone 20mg / d, ifosfamide 1200mg / (m2.d) and cisplatin 25mg / (m2). d) and etoposide 80mg / (m2.d), were added to the normal saline intravenously, d1 ~ d4, 21d for a cycle, observation of efficacy, KPS score changes, survival and adverse reactions. Results: All 42 patients completed 6 cycles of DICE chemotherapy. The total effective rate was 61.90%, the complete remission rate was 33.33% and the partial remission rate was 28.57%. The total effective rates of T and B cells were 64.29% and 57.14%, respectively, P = 0.65. The total effective rates of refractory and relapsed patients were 63.16% and 60.87%, respectively, P = 0.88. 53.57% and 78.57% respectively, P = 0.12. KPS score improved 73.81%, the median survival of 19 months (5 to 61 months), 3-year survival rate of 35.71%. The main adverse reactions were nausea and vomiting, myelosuppression and hair loss, which were recovered after treatment. Conclusion: The DICE regimen is safe and effective in the treatment of refractory or recurrent non-Hodgkin’s lymphoma.