Comparative Study Of R-GEMOX And RICE Regimens As Second-line Treatments For Refractory Or Relapsed DLBCL

Objective:To compare the efficacy and safety of R-GemOx and RICE regimens for treating relapsed or refractory non-Hodgkin’s lymphoma (NHL).Methods:Up to60cases with relapsed and refractory diffuse large B cell lymphoma (DLBCL) were randomly divided into two groups. These patients received R-GemOx and RICE regime, respectively. The R-GemOx group regimen included rituximab at375mg/m2, ivd, d0; GEM at 1000mg/m2, ivd, d1,8; and L-OHP at 130mg/m2, ivd, dlat21days per cycle. The RICE group regime included rituximad at375mg/m2, ivd, d0; IFO atlg/m2, ivd, dl-d3; Mesna at400mg, ivd q8h, dl-d3; CBP AUC=5, ivd, d2; and Vp-16at100mg/m2, ivd, dl-d3 at21days per cycle. Their efficacy and safety were evaluated every two weeks.Results:For the R-GemOx group, complete remission (CR) was achieved in 6 cases (20.0%), partial remission (PR) in 14 cases (46.7%), stable disease (SD) in 7 cases, and progressive disease (PD) in 3 cases. The overall response rate (CR+PR) was66.7%, and the clinical benefit rate (CR+PR+SD) was 90.0%. For the RICE group, CR was achieved in 5 cases (16.7%), PR in 14 cases (46.7%), SD in 7 cases, and PD in 4 cases. The overall response rate (CR+PR) was 63.4%, and the clinical benefit rate (CR+PR+SD) was 86.7%. The main side effect was bone marrow suppression. In the R-GemOx group, leukopenia was observed with 6 cases at gradeⅢ,and 5 cases at gradeⅣ;anemia was observed with 2 cases at gradeⅢ; thrombocytopenia was observed with 2 cases at gradeⅢand 0 cases at gradeⅣ. In the RICE group, leukopenia was observed with 10 cases at gradeⅢand 5 cases at gradeⅣ; anemia was observed with 2 cases at gradeⅢ;thrombocytopenia was observed with 3 cases at gradeⅢ and 2 cases at gradeⅣ. The gastrointestinal tract reaction in the RICE group was more serious than in the R-GemOx group:2 cases at gradeⅢand 1 case at gradeⅣ. Comparison of the side effects in the two groups revealed that R-GemOx group was better for neutrocytopenia and gastrointestinal tract reaction than RICE group(P> 0.05).Conclusion:R-GemOx and RICE boss are a safer and more effective regimen for treating relapsed or refractory DLBCL, and its efficacy requires observation and research.