ESHAP versus GEMOX in Management of Relapsed or Refractory Lymphoma: A Prospective Randomized Study | ||||
| Research in Oncology | ||||
| Article 4, Volume 14, Issue 1, June 2018, Page 12-16 PDF (312.61 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/resoncol.2018.3040.1048 | ||||
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| Authors | ||||
Hamdy Zawam1; Wael Edesa 1; Sherif Alrefai2; Rasha Salama1; Ahmed Abdelhafeez  1
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| 1Clinical Oncology Department, Kasr Al-Ainy Center of Clinical Oncology and Nuclear Medicine, Kasr Al-Ainy School of Medicine, Cairo University, Cairo, Egypt | ||||
| 2Nuclear Medicine Department, Kasr Al-Ainy Center of Clinical Oncology and Nuclear Medicine, Kasr Al-Ainy School of Medicine,Cairo University, Cairo, Egypt | ||||
| Abstract | ||||
| Background: There is lack of evidence about the best chemotherapy regimen in treatment of relapsed/refractory Hodgkin's lymphoma (HL) and aggressive non-Hodgkin’s lymphoma (NHL) lymphoma. Aim: To compare GEMOX (gemcitabine, oxaliplatin) with ESHAP (etoposide, methylprednisolone, cytarabine arbinoside, cisplatin) regimes as 2nd line in lymphomas. Methods: This was a prospective randomized study that included relapsed/refractory HL and aggressive NHL patients who failed 1st line chemotherapy. After assessment for eligibility, patients were randomized to receive GEMOX or ESHAP. Results: The study included 41 patients, 21 of them received GEMOX and 20 received ESHAP. The response rate did not differ significantly between the GEMOX and ESHAP arms (28.6% vs. 35%, p=0.793) as well as progression free survival (8.7 months vs. 6.6 months, p=0.711). By univariate analysis for the whole group, the response rate differed significantly according to disease status at relapse, time to relapse, lactate dehydrogenase, International Prognostic Index (IPI) and secondary age-adjusted IPI (2ry aa-IPI). Hematological toxicity was not statistically different between the two treatment arms. GEMOX was associated with significantly less vomiting of any grade (p=0.013). Acute renal toxicity of any grade was significantly lower in GEMOX compared to ESHAP (p=0.003). In terms of peripheral neuropathy, GEMOX was associated with significantly higher all grades (p=0.0001). Conclusion: The current study results suggest that the response rate and progression free survival of GEMOX and ESHAP are comparable with different toxicity profile. | ||||
| Keywords | ||||
| Relapsed/refractory lymphoma; GEMOX; ESHAP | ||||
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