Zawam, H., Edesa, W., Alrefai, S., Salama, R., Abdelhafeez, A. (2018). ESHAP versus GEMOX in Management of Relapsed or Refractory Lymphoma: A Prospective Randomized Study. Research in Oncology, 14(1), 12-16. doi: 10.21608/resoncol.2018.3040.1048
Hamdy Zawam; Wael Edesa; Sherif Alrefai; Rasha Salama; Ahmed Abdelhafeez. "ESHAP versus GEMOX in Management of Relapsed or Refractory Lymphoma: A Prospective Randomized Study". Research in Oncology, 14, 1, 2018, 12-16. doi: 10.21608/resoncol.2018.3040.1048
Zawam, H., Edesa, W., Alrefai, S., Salama, R., Abdelhafeez, A. (2018). 'ESHAP versus GEMOX in Management of Relapsed or Refractory Lymphoma: A Prospective Randomized Study', Research in Oncology, 14(1), pp. 12-16. doi: 10.21608/resoncol.2018.3040.1048
Zawam, H., Edesa, W., Alrefai, S., Salama, R., Abdelhafeez, A. ESHAP versus GEMOX in Management of Relapsed or Refractory Lymphoma: A Prospective Randomized Study. Research in Oncology, 2018; 14(1): 12-16. doi: 10.21608/resoncol.2018.3040.1048
ESHAP versus GEMOX in Management of Relapsed or Refractory Lymphoma: A Prospective Randomized Study
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.
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