[1군 항암제 단독 또는 병용요법]
연번 항암요법
1 cyclophosphamide + prednisolone or dexamethasone 2 cyclophosphamide + vincristine + prednisolone
3 cyclophosphamide + vincristine + prednisolone + daunorubicin
4 cyclophosphamide + doxorubicin + vincristine + prednisolone or dexamethasone
5 cyclophosphamide + doxorubicin + vincristine + prednisolone + (high-dose) methotrexate 6 cytarabine + etoposide
7 cytarabine + methotrexate
8 cytarabine + (high-dose) methotrexate
9 cytarabine(IT) + methotrexate(IT) + hydrocortisone(IT) 10 vincristine + daunorubicin + L-asparaginase + prednisolone 11 bleomycin + cisplatin + etoposide
12 bleomycin + vincristine + prednisolone 13 chlorambucil(PO)
14 cisplatin + etoposide + mitoxantrone + dexamethasone 15 cyclophosphamide
16 cyclophosphamide + vincristine + prednisolone + bleomycin + etoposide + methotrexate 17 cyclophosphamide + vincristine + prednisolone + bleomycin + methotrexate
18 cyclophosphamide + vincristine + prednisolone + etoposide + epirubicin 19 cyclophosphamide + vincristine + prednisolone or dexamethasone + epirubicin
20 cyclophosphamide + vincristine + prednisolone + procarbazine(비급여) (제2011-106호: 2011.10.1)
21 cyclophosphamide + doxorubicin + vincristine + prednisolone + bleomycin + etoposide + methotrexate
22 cyclophosphamide + doxorubicin + vincristine + prednisolone + bleomycin + cytarabine + etoposide + methotrexate
23 cyclophosphamide + doxorubicin + vincristine + prednisolone + bleomycin + methotrexate 24 cyclophosphamide + doxorubicin + vincristine + prednisolone + bleomycin +
procarbazine(비급여) (제2011-106호: 2011.10.1)
25 cyclophosphamide + doxorubicin + vincristine + prednisolone + bleomycin
111
연번 항암요법
26 cyclophosphamide + doxorubicin + vincristine + prednisolone + cytarabine + etoposide + L-asparaginase + methotrexate
27 cyclophosphamide + doxorubicin + vincristine + prednisolone + etoposide 28 cyclophosphamide + doxorubicin + vincristine + prednisolone + L-asparaginase
29 cyclophosphamide + doxorubicin + vincristine + dexamethasone + methylprednisolone + methotrexate + cytarabine
30 cyclophosphamide + doxorubicin + vincristine + cytarabine + etoposide + ifosfamide + methotrexate
31 cyclophosphamide + cisplatin + etoposide 32 cyclophosphamide + cytarabine
33 cyclophosphamide + doxorubicin + vincristine + etoposide 34 cyclophosphamide + doxorubicin + vincristine + methotrexate
35 cyclophosphamide + doxorubicin + dexamethasone + etoposide + methotrexate 36 cyclophosphamide + doxorubicin + etoposide
37 cyclophosphamide + (high-dose) etoposide + procarbazine(비급여) + prednisolone (제2011-106호: 2011.10.1) 38 cyclophosphamide + etoposide + procarbazine(비급여) + prednisolone (제2011-106호: 2011.10.1)
39 cytarabine
40 cytarabine + carboplatin + mitoxantrone + methylprednisolone (2차 이상으로 사용 시 요양급여 인정) 41 cytarabine + carboplatin + etoposide (2차 이상으로 사용 시 요양급여 인정)
42 cytarabine + cisplatin + doxorubicin + methylprednisolone 43 cytarabine + cisplatin + etoposide + methylprednisolone 44 cytarabine + cisplatin + dexamethasone
45 cytarabine + cisplatin
46 cytarabine + chlorambucil + vincristine
47 cytarabine + etoposide + ifosfamide + methotrexate
48 cytarabine + etoposide + ifosfamide + methotrexate + dexamethasone 49 cytarabine + etoposide + ifosfamide
50 cytarabine + methotrexate + methylprednisolone
연번 항암요법
51 ifosfamide + carboplatin + etoposide (2차 이상으로 사용 시 요양급여 인정) 52 ifosfamide + cisplatin + etoposide + dexamethasone
53 ifosfamide + etoposide + methotrexate
54 ifosfamide + etoposide + methotrexate + prednisolone
55 ifosfamide + etoposide + methotrexate + dexamethasone + L-asparaginase 56 ifosfamide + etoposide + mitoxantrone
57 ifosfamide + methotrexate + hydrocortisone
58 (high-dose) ifosfamide + carboplatin + etoposide (2차 이상으로 사용 시 요양급여 인정)
59
interferon alpha-2a
※ ‘피부 T세포 림프종(cutaneous T-cell lymphoma)’과 식약처 허가범위를 초과하여 ‘소포림프종 (follicular lymphoma)’에 투여 시 요양급여를 인정함
60 methotrexate(IV, PO) + vincristine 61 methotrexate
62 methotrexate + procarbazine(비급여) + vincristine (제2011-106호: 2011.10.1) 63 methotrexate + mercaptopurine + vincristine + prednisolone
64 cyclophosphamide + vincristine + prednisolone + cytarabine + daunorubicin + L-asparaginase + mercaptopurine
65 cyclophosphamide + vincristine + prednisolone + cytarabine + L-asparaginase + methotrexate + thioguanine(비급여) (제2011-106호: 2011.10.1)
66 cyclophosphamide + vincristine + prednisolone or dexamethasone + cytarabine + daunorubicin + L-asparaginase + mercaptopurine
67 cyclophosphamide + vincristine + prednisolone + cytarabine + (high-dose) methotrexate 68 cyclophosphamide + vincristine + prednisolone + daunorubicin + L-asparaginase
69 cyclophosphamide + vincristine + prednisolone + daunorubicin + methotrexate
70 cyclophosphamide + vincristine + prednisolone + daunorubicin + (high-dose) methotrexate 71 cyclophosphamide + vincristine + dexamethasone or prednisolone + methotrexate
72 cyclophosphamide + doxorubicin + vincristine + prednisolone + bleomycin + procarbazine(비급여) + vinblastine (제2011-106호: 2011.10.1)
73 cyclophosphamide + doxorubicin + vincristine + prednisolone + (high-dose) cytarabine + etoposide + L-asparaginase + methotrexate + thioguanine(비급여) (제2011-106호: 2011.10.1)
74 cyclophosphamide + doxorubicin + vincristine + dexamethasone + cytarabine + L-asparaginase + thioguanine(비급여) (제2011-106호: 2011.10.1)
113
주1. 위에서 언급한 ‘prednisolone’, ‘dexamethasone’, ‘methylprednisolone’은 환자의 상태 등에 따라 필요․
적절하게 경구투여(PO) 또는 정맥내투여(IV) 시 요양급여를 인정함
2. 위에서 언급한 ‘L-asparaginase’는 환자 상태 등에 따라 필요·적절하게 근육내투여(IM), 피하투여(SC) 또는 정맥내투여(IV) 시 요양급여를 인정함
연번 항암요법
75 cyclophosphamide + doxorubicin + vincristine + prednisolone + cytarabine + methotrexate + thioguanine(비급여) (제2011-106호: 2011.10.1)
76 cyclophosphamide + doxorubicin + vincristine + dexamethasone or prednisolone + cytarabine + L-asparaginase + mercaptopurine
77 cyclophosphamide + doxorubicin + vincristine + prednisolone + mercaptopurine + (high-dose) methotrexate
78 cyclophosphamide + cytarabine + mercaptopurine
79 cyclophosphamide + cytarabine + (high-dose) methotrexate + vincristine 80 cyclophosphamide + doxorubicin + dexamethasone + methotrexate 81 cytarabine + doxorubicin + dexamethasone + ifosfamide + methotrexate 82 cytarabine + L-asparaginase + prednisolone
83 cytarabine + L-asparaginase + methotrexate + thioguanine(비급여) + vincristine (제2011-106호: 2011.10.1) 84 cytarabine + etoposide + L-asparaginase + methotrexate + thioguanine(비급여) + vincristine
(제2011-106호: 2011.10.1)
85 cytarabine + etoposide + ifosfamide + L-asparaginase + (high-dose) methotrexate + dexamethasone or prednisolone
86 (high-dose) cytarabine + cytarabine + etoposide
87 (high-dose) cytarabine + cisplatin + dexamethasone + etoposide + L-asparaginase
88 (high-dose) cytarabine + cisplatin + dexamethasone + etoposide + ifosfamide + L-asparaginase 89 (high-dose) cytarabine + cytarabine + etoposide + (high-dose) methotrexate
90 etoposide + ifosfamide 91 (high-dose) methotrexate
92 (high-dose) methotrexate + mercaptopurine 93 methotrexate(PO) + mercaptopurine
94 methotrexate(IT)
95 vincristine + prednisolone + daunorubicin 96 vincristine + prednisolone + L-asparaginase
97 vincristine + prednisolone + mercaptopurine + methotrexate(PO)
3. ‘cytarabine’, ‘methotrexate’, ‘hydrocortisone’ 약제는 환자의 상태 및 진료의사의 의학적 판단에 따라 상기요법 외에 척수강내(intrathecal)로 필요․적절하게 추가 투여 가능함
4. ‘methotrexate’ 사용 시 ‘leucovorin’은 사용 가능함 5. ‘methotrexate’를 포함한 항암요법 관련:
고위험군의 비호지킨림프종[CNS lymphoma, 고등급 림프종(IWF 분류기준의 high grade)], 재발성 중등급 이상 림프종(IWF 분류기준의 intermediate grade, high grade)에 고용량 ‘methotrexate’(≥1g/㎡)를 투여한 경우(주사제에 한함) 요양급여를 인정함
6. ‘daunorubicin’을 포함한 항암요법, ‘mercaptopurine’을 포함한 항암요법 관련:
‘daunorubicin’과 ‘mercaptopurine’은 비호지킨림프종에 식약처 허가초과인 약제로서 식약처 허가범위를 초과하여 비호지킨림프종의 sub-type 중 〈림프모구림프종(lymphoblastic lymphoma)〉에 투여한 경우 요양급여를 인정함
115
cyclophosphamide + vincristine + prednisolone (R-CVP)
CD20 양성인 소포림프종(follicular lymphoma), 변연부B세포림프종(marginal zone B-cell lymphoma) 중
stage Ⅲ, Ⅳ(Ann Arbor 병기분류 체계＊) (투여기간 : 6~8 주기)
1차 (제2010-12호: 2010.12.15, 개정2016-22호:
2016.2.1, 개정 제2016-242호: 2016.9.1)
3
rituximab(IV,SC주3) +
cyclophosphamide + doxorubicin + vincristine + prednisolone
(R-CHOP)
가. CD20 양성인 광범위큰B세포림프종(Diffuse Large B-cell Lymphoma) (투여기간 : 6~8 주기)
소포림프종(follicular lymphoma),
소림프구림프종(small lymphocytic lymphoma), 외투세포림프종(mantle cell lymphoma),
림프형질세포림프종(lymphoplasmacytic lymphoma / Waldenström’s macroglobulinemia),
변연부B세포림프종(marginal zone B-cell lymphoma)
6 fludarabine + mitoxantrone (제2009-7호: 2009.12.1)
7 fludarabine + cyclophosphamide (제2009-7호: 2009.12.1)
8
fludarabine + cyclophosphamide + mitoxantrone
(제2009-7호: 2009.12.1)
9 brentuximab 재발성 또는 불응성의 CD30 양성인 전신역형성대세포림프종
(systemic Anaplastic Large Cell Lymphoma, sALCL) 2차 이상 (제2016-22호: 2016.2.1)
주1. ‘ibritumomab tiuxetan(품명: 제바린키트주)’: ‘ibritumomab tiuxetan’는 비급여 약제로서, 병용투여되는
bortezomib + rituximab(IV, SC주3) + cyclophosphamide + doxorubicin +
cyclophosphamide + doxorubicin + vincristine +
dexamethasone(R-hyper CVAD) alternating methotrexate + cytarabine
가. CD20 양성인 Ann Arbor stage Ⅲ, Ⅳ의 외투세포림프종 (mantle cell lymphoma)
(투여기간: 8주기)
나. 이전에 치료받은 적 없는(새로이 진단된) CD20 양성인 1차 Ann Arbor Stage II-IV Burkitt's lymphoma/ leukemia (투여기간: 8주기)
(제2018-21호: 2018.2.1)
13 rituximab(IV, SC주3) + bendamustine CD20 양성인 소포림프종(follicular lymphoma) 중
stage III, IV(Ann Arbor 병기분류 체계＊) (투여기간: 6주기) 1차 (제2018-210호: 2018.9.1)
117