The effect of CHEP combination chemotherapy in previously untreated non-Hodgkin's lymphoma / 대한내과학회지
Korean Journal of Medicine
;
: 52-61, 2007.
Article
in Korean
| WPRIM
| ID: wpr-116435
ABSTRACT
BACKGROUND:
The CHOP regimen has been the standard therapy for non-Hodgkin's lymphoma (NHL) for the past 30 years, but its effect on complete response and long-term survival rates were unsatisfactory. Therefore, more effective chemotherapeutic regimens are required. We attempted to treat non-Hodgkin's lymphoma with a newly developed cyclophosphamide, adriamycin, etoposide, prednisolone (CHEP) combination chemotherapy which substitutes etoposide for vincristine in a preexisting cyclophosphamide, adriamycin, prednisolone, vincristine (CHOP) regimen.METHODS:
Between March 1997 and April 2003, 36 patients with a histologically confirmed NHL were enrolled in the study. All patients received CHEP chemotherapy as a first-line treatment. Tratment courses were repeated every 34 weeks for at least 4 cycles, pending response to the treatment.RESULTS:
The overall response rate achieved was 86.1% for all of the patients. The complete response (CR) and partial response (PR) rates were 72.2% and 13.9%, respectively. The CR rate was significantly higher in patients with stage III disease, and a PS score of 02 (p<0.0001, p=0.017, respectively). The three year overall (OS) and failure-free survival (FFS) rates were 61.2%, 58.2%, respectively. Stage, extranodal involvement, and the attainment of CR influenced OS significantly (p=0.027, p=0.047, p=0.0001, respectively) as determined by univariate analysis. Stage, serum LDH level, extranodal involvement, the international prognostic index (IPI), and the attainment of CR influenced FFS significantly (p=0.0013, p=0.048, p=0.020, p=0.018, p=0.0001, respectively) as determined by univariate analysis. The dose-limiting toxicity was due to myelosuppression. Nno neurologic side effects were seen, which frequently occur after using vincristine.CONCLUSIONS:
The CHEP regimen in patients with aggressive NHL is effective as a first-line therapy, and possesses an acceptable toxicity profile. We suggest a trial that adds rituximab to the CHEP regimen as afirst-line therapy for aggressive NHL in the future.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Vincristine
/
Lymphoma, Non-Hodgkin
/
Prednisolone
/
Doxorubicin
/
Survival Rate
/
Cyclophosphamide
/
Drug Therapy
/
Drug Therapy, Combination
/
Etoposide
/
Rituximab
Type of study:
Prognostic study
Limits:
Humans
Language:
Korean
Journal:
Korean Journal of Medicine
Year:
2007
Type:
Article
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