What Is the R-ICE Chemotherapy Protocol?

R-ICE is a treatment for non-Hodgkin’s and Hodgkin’s lymphoma. It combines four chemotherapy drugs that kill cancer cells and is often used prior to a stem cell transplant.

R-ICE is a chemotherapy protocol that combines a variety of drugs that aim to destroy cancer cells. It’s given in an outpatient setting through an intravenous (IV) drip.

Like all types of chemo, it can cause side effects like nausea, vomiting, and hair loss. However, it can improve outlook and survival rates for people with lymphoma.

Read on to learn more about the R-ICE chemo protocol.

What is it?

There are many chemotherapy drugs that work differently and are used to treat various forms of cancer. Sometimes, drugs are used together in order to target certain cancers. The R-ICE protocol is an example of this.

R-ICE combines four chemotherapy drugs :

• rituximab
• ifosfamide
• carboplatin
• etoposide Phosphate

Uses

R-ICE is often used as a treatment for non-Hodgkin’s lymphoma , and it’s also used for Hodgkin’s lymphoma that has returned. In some cases, it’s considered a second-line treatment for non-Hodgkin lymphoma.

Sometimes, it’s used to treat lymphomas of the brain, spinal cord, or central nervous system.

R-ICE shrinks lymphoma cells and can help control symptoms. Typically, people who receive R-ICE treatment have a stem cell transplant after their R-ICE treatment is complete.

What to expect

While R-ICE used to be an inpatient procedure, meaning you’d need to stay in the hospital, some cancer centers are moving to an outpatient approach.

This means that you only need to go into the hospital for a set period of time and can go home the same day. You’ll receive medication through an IV line.

Your exact treatment schedule can vary depending on your treatment center and your doctor’s order. It’s usually given in 3-week cycles , and you may need multiple cycles.

A typical 3-week treatment plan can include:

• Day 1: 1 hour of IV-drip treatment
• Day 2: 24 hours of IV-drip treatment
• Day 3: 1 hour of IV-drip treatment
• Days 4 to 21: no active drip treatment

Side effects

Like all forms of chemotherapy treatment, there are side effects associated with receiving R-ICE treatment. These can include :

• loss of appetite
• nausea
• vomiting
• hair loss
• bleeding
• bruising
• constipation
• fatigue
• weakness
• stomach pain
• kidney damage

Some people experience additional side effects. These may include:

• dizziness
• diarrhea
• skin rashes
• itchy skin
• changes in the way food tastes
• mouth sores
• visual changes
• lung problems
• numbness in the fingers or toes

Rarely, people receiving treatment can experience more serious side effects. These include:

• seizures
• serious allergic reactions
• serious skin reactions

Success rate

The success rate of R-ICE chemotherapy depends on multiple factors. Variables such as a person’s specific type of cancer, their age, their genetics, and their cancer stage can all play a large role in treatment success.

Your doctor can help you understand your outlook and how effective R-ICE might be for you.

Who is a good candidate?

R-ICE is typically intended for people who will also be having a stem cell transplant. Most people who have this treatment have non-Hodgkin’s lymphoma or Hodgkin’s lymphoma.

Your cancer team can discuss your treatment options with you.

Outlook

The outlook for people who receive R-ICE treatment varies. Factors such as stage of cancer, type of cancer, age, and overall health can all make a difference.

The relative 5-year survival rate for people with people with Hodgin’s lymphoma is 89% . The relative 5-year survival rate for people with non-Hodgkin’s lymphoma ranges between 65% and 90% depending on the cancer type .

When to contact your doctor

It’s important to stay in close communication with your doctor while you’re receiving R-ICE treatment. It’s best to contact them right away if you experience any of these side effects:

• rash
• bleeding or bruising
• chills
• swelling in your mouth or throat
• trouble swallowing
• severe itching
• severe headaches or other pain
• skin discoloration or soreness at your IV drip site
• shortness of breath
• vomiting or diarrhea that doesn’t fade
• blood in urine
• blood in stool
• fever

If you’re having trouble breathing or are experiencing symptoms that could signal a serious allergic reaction, call 911. These may be signs of a medical emergency.

Frequently asked questions

How long does treatment last?

R-ICE treatment is given in cycles, usually lasting 3 weeks. Your total treatment may include multiple cycles.

Will R-ICE treatment cause hair loss?

Hair loss is a known side effect of chemotherapy treatment. However, only some people who receive R-ICE treatment lose their hair.

Overall, 65% of people who receive chemotherapy experience some hair loss.

Is it safe to get pregnant during treatment?

R-ICE chemotherapy isn’t safe during pregnancy. If you’re currently or may become pregnant, your doctor will recommend alternative treatment methods.

The bottom line

R-ICE is a chemotherapy treatment protocol that combines four different chemotherapy drugs. It’s used to treat non-Hodgkin’s and Hodgkin’s lymphomas.

Typically, people who receive R-ICE treatment also receive a stem cell transplant. Success rates can vary depending on factors such as cancer stage and a person’s age and genetics.