Therapy with of RCHOP-14 Versus RCHOP-21 for People With Aggressive or Advanced Stage Indolent B-Cell Non-Hodgkins Lymphoma: A Systematic Review and Meta-Analysis

Abstract Background: With the advent of rituximab, RCHOP is considered the appropriate chemotherapy for aggressive or advanced stage indolent B-cell Non-Hodgkins Lymphoma(NHL). RCHOP-14 seems to achieve better outcomes than RCHOP -21 in aggressive or advanced stage indolent B-cell NHL patients in recent years.Methods: To verify the befitting chemotherapy regimens for B-cell NHL patients, we searched the electronic databases for relevant English-language literature published through January 2020. The primary outcomes were complete response(CR),progression-free survival (PFS), overall survival(OS), and Adverse events (AEs). Six eligible Phase II and III clinical randomized controlled trials (RCTs) and two high-quality observational comparative studies (OCSs)were extracted, and 5565 B-cell NHL patients involved in evaluable.Results: The analysis demonstrated no significant difference for CR rate (OR= 0.98,95%CI 0.77-1.24，P=0.85)between RCHOP-14 and RCHOP-21. Compared with RCHOP-21, the merged hazard ratio (HR) for PFS and OS was, respectively, 0.94 (95% CI: 0.84-1.06, P=0.32) and 0.91(95% CI: 0.83-1.01, P= 0.08) after treatment with RCHOP-14.A subgroup analysis based on the international prognostic index(IPI) score showed that both chemotherapy regimens were applicable in B-cell NHL patients with different prognosis. The frequency of toxic side-effects was similar between schemes.Conclusions: Therefore, the data presented suggest that the efficacy and safety of both regimens are comparable and that R-CHOP14 remains a viable plan in B-cell NHL patients who prefer a shorter therapy course.