| The effect of CHEP combination chemotherapy in previously untreated non-Hodgkin's lymphoma |
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Won Sik Lee, Young Don Joo, Chang Hak Sohn |
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고려대학교 의과대학 내과학교실 |
| 원저: 비호지킨 림프종에서 CHEP 복합화학요법의 치료효과 |
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이원식, Young Don Joo, Chang Hak Sohn |
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| 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.(Korean J Med 72:52-61, 2007)
Key Words : Lymphoma, Chemotherapy
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| Key Words:
Lymphoma, Chemotherapy |
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