Epelbaum R, Haim N, Ben-Shahar M, Ron Y, Cohen Y
Department of Oncology, Rambam Medical Center, Haifa, Israel.
Isr J Med Sci. 1988 Sep-Oct;24(9-10):533-8.
Dose intensity may play an important role in the success of cancer chemotherapy. We have investigated the relationship between RDI of the combination of cyclophosphamide, adriamycin, vincristine and prednisone (CHOP) and the results of therapy in a group of 78 newly diagnosed patients with diffuse histiocytic and diffuse mixed non-Hodgkin's lymphoma. The achievement of CR was associated with high DI. In the initial cycles needed to achieve a maximal response, a significantly greater proportion of complete responders received average RDI, RDI of CTX and RDI of adriamycin greater than 0.8, as compared with noncomplete responders: 52 vs. 23%, 62 vs. 34% and 61 vs. 29%, respectively (P less than 0.05). Sixty-one patients achieved CR. Among these, RDI of CTX was best and significantly correlated with survival: 81 and 54% 5-year actuarial survival of patients receiving greater than 0.7 and less than 0.7 RDI, respectively (P less than 0.05). Our data indicate that there is a clear dose-rate effect of CHOP, particularly of CTX, on the therapeutic outcome. High DI may improve results of treatment in patients with diffuse, large cell lymphoma.
剂量强度可能在癌症化疗的成功中发挥重要作用。我们研究了环磷酰胺、阿霉素、长春新碱和泼尼松联合方案（CHOP）的相对剂量强度（RDI）与一组78例新诊断的弥漫性组织细胞性和弥漫性混合性非霍奇金淋巴瘤患者治疗结果之间的关系。完全缓解（CR）的实现与高剂量强度相关。在达到最大反应所需的初始疗程中，与未完全缓解者相比，完全缓解者中接受平均RDI、环磷酰胺RDI和阿霉素RDI大于0.8的比例显著更高：分别为52%对23%、62%对34%和61%对29%（P小于0.05）。61例患者实现了CR。其中，环磷酰胺的RDI最佳，且与生存率显著相关：接受RDI大于0.7和小于0.7的患者5年精算生存率分别为81%和54%（P小于0.05）。我们的数据表明，CHOP方案，尤其是环磷酰胺，对治疗结果有明显的剂量率效应。高剂量强度可能改善弥漫性大细胞淋巴瘤患者的治疗效果。
