Effectiveness and Safety of Chemotherapy Regimens Represented by Pirarubicin versus Adriamycin Hydrochloride for Non-Hodgkin Lymphoma in Mainland China: A Meta-Analysis_Chinese Journal of Evidence-Based Medicine

Authors：

 LI Hui , WANG Xiaodong , WANG Chunsen

Department of Hematology, Sichuan Academy of Medical Sciences & Sichuan Provincial People’s Hospital, Chengdu 610072, China;

Corresponding author：

LI Hui, Email: lihui606606@163.com

Keywords：

Pirarubicin; Adriamycin hydrochloride; Non-Hodgkin lymphoma; Randomized controlled trial; Meta-analysis; Systematic review

DOI：

10.7507/1672-2531.20130031

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective 　To evaluate the effectiveness and safety of chemotherapy regimens represented by pirarubicin (THP) vs. adriamycin hydrochloride (ADM) for non-Hodgkin lymphoma (NHL) in mainland China.
Methods 　The randomized controlled trials (RCTs) about THP vs. ADM for treating NHL were collected in the databases such as CNKI, CBM, VIP and WanFang Data, and the references of the included studies were also retrieved manually, with the retrieval time from January 1989 to September 2012. According to the inclusion and exclusion criteria, two reviewers independently screened articles, extracted data, and assessed the methodological quality of the included studies. Then meta-analysis was performed using RevMan 5.0 software.
Results 　A total of 15 RCTs involving 1 659 patients were included. The results of meta-analysis showed that: a) As for the total effective rate, the CTOP (C: cyclophosphamide, T: pirarubicin, O: vincristine, P: prednison) regimen was superior to the CHOP (C: cyclophosphamide H: adriamycin hydrochloride, O: vincristine, P: prednison) regimen with a significant difference (OR=1.07, 95%CI 1.02 to 1.12, P=0.006); and b) As for the safety, there were significant differences between the two groups in the incidence of cardiac toxicity (OR=0.42, 95%CI 0.30 to 0.57, P lt;0.000 01), gastrointestinal tract response (OR=0.69, 95%CI 0.56 to 0.85, P=0.000 5) and liver damage (OR=0.69, 95%CI 0.48 to 1.00, P=0.05). But no significant differences were found between the two groups in the incidence of mye1osuppression: the decreased hemoglobin (OR=0.83, 95%CI 0.61 to 1.14, P=0.25), leucopenia (OR=0.85, 95%CI 0.68 to 1.07, P=0.17), and thrombocytopenia (OR=0.99, 95%CI 0.70 to 1.39, P=0.95).
Conclusion 　Based on the domestic evidences at current and compared with CHOP regimen represented by ADM, CTOP regimen represented by THP for treating NHL shows a higher total effective rate and less side effects. However, more high quality, large sample and double blind RCTs are required to prove this conclusion for the quality and quantity limitation of the included studies.

Citation： LI Hui,WANG Xiaodong,WANG Chunsen. Effectiveness and Safety of Chemotherapy Regimens Represented by Pirarubicin versus Adriamycin Hydrochloride for Non-Hodgkin Lymphoma in Mainland China: A Meta-Analysis. Chinese Journal of Evidence-Based Medicine, 2013, 13(2): 176-181. doi: 10.7507/1672-2531.20130031 Copy

1.	王彦艳, 沈志祥. 非霍奇金侵袭性B细胞淋巴瘤治疗进展. 实用医院临床杂志, 2007, 4(6): 4-5.
2.	张玉生. 吡柔比星为主的联合化疗方案治疗老年非霍奇金淋巴瘤临床研究干扰素加AVP方案与单纯AVP方案治疗多发性骨髓瘤的疗效比较. 中国医药导报, 2010, 7(4): 8-9.
3.	林晓燕, 郭学凤, 李凤菊, 等. 吡柔比星为主联合化疗方案治疗老年非霍奇金淋巴瘤临床分析. 当代医学, 2012, 18(2): 140-141.
4.	胡正操, 李永杰, 曾宪亮. 吡柔比星与阿霉素为主的方案治疗非霍奇金淋巴瘤30例疗效比较. 医学临床研究, 2011, 28(7): 1258-1262.
5.	陈小林, 赖应昌, 冯秀娟. 吡柔比星治疗非霍奇金淋巴瘤(附51例报告). 医学新知杂志, 2006, 16(6): 369-370.
6.	张之南. 血液病诊断及疗效标准. 2版. 北京: 科学出版社, 1998: 342-359.
7.	孙燕, 王少章, 刘丽影, 等. 临床肿瘤内科手册. 北京: 人民卫生出版社, 1996: 59.
8.	Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. The Cochrane Collaboration, 2011. Available from www.cochranehandbook. org.
9.	倪宗赞. 医学统计学. 北京: 高等教育出版社, 2003: 241-251.
10.	闫轶鹏. 吡柔比星为主联合化疗方案治疗老年非霍奇金淋巴瘤. 中国临床实用医学. 2010, 4(2):151-152.
11.	高建湘, 周定, 王平辉, 等. 吡柔比星与阿霉素治疗非何杰金氏淋巴瘤的效果比较. 中国肿瘤临床与研究, 1999, 6(6): 63-64.
12.	崔钊, 刘小琴. 吡柔比星与阿霉素治疗非霍奇金淋巴瘤的对比观察. 肿瘤研究与临床, 2003, 15(1): 59-60.
13.	刘汉锋. 化疗辅加吡柔比星治疗老年人恶性淋巴瘤临床疗效观察. 中国肿瘤临床, 2001 28(2): 121-122.
14.	许丹丹, 吴燕明, 丁后明. 以吡柔比星为主联合化疗方案治疗非霍奇金淋巴瘤的临床观察. 吉林医学, 2011, 32(35): 7484-7485.
15.	徐聪琴, 陈善, 郑翠苹. 以吡柔比星为主联合化疗方案治疗老年非霍奇金淋巴瘤的临床观察. 现代实用医学, 2009, 2(5): 492-493.
16.	张敬东, 谢鹏鸿, 刘旭梅. 吡柔比星为主联合治疗老年非霍奇金淋巴瘤临床观察. 中国肿瘤临床与康复, 2009, 16(5): 426-427.
17.	童浩, 王继生, 秦健秀. CTOP与CHOP方案治疗老年非霍奇金淋巴瘤的临床对照研究. 临床血液学杂志, 2008, 21(7): 379-380.
18.	秦玲, 张华, 王朝刚, 等. 以吡柔比星为主联合化疗方案治疗非霍奇金淋巴瘤的临床观察. 白血病·淋巴瘤, 2008, 17(5): 381-382.
19.	王彦艳, 张晋林, 王椿, 等. CTOP与CHOP方案治疗初治侵袭性非霍奇金淋巴瘤患者疗效分析. 中华血液学杂志, 2010, 31(10): 649-653.
20.	Zhai LZ, Guo CC, Cao YB, et al. Long-term results of pirarubicin versus doxorubicin in combination chemotherapy for aggressive non-Hodgkin’s lymphoma: single center, 15-year experience. Int J Hematol, 2010, 91(1): 78-86.
21.	王英娟, 綦振家, 孙晓琳. 等. 42例非霍奇金淋巴瘤性白血病临床分析. 临床荟萃. 2007, 22(22): 1637-1638.
22.	吴晓雄, 曹永彬, 刘周阳, 等. 伊立替康联合米托恩醌治疗难治/复发性非霍奇金淋巴瘤的疗效观察. 临床血液学杂志, 2009, 22(4): 366-367.
23.	贾彦焘, 贾英杰, 赵成, 等. 吡柔比星联合化疗治疗晚期肿瘤37例临床观察. 肿瘤研究与临床, 2005, 17(1): 36.
24.	佐藤靖. 吡柔比星在T细胞淋巴瘤中的内吞作用和杀细胞作用. 新药临床, 1999, 48(3): 327.
25.	Tsurumi H, Yamada T, Sawada M, et al. Biweekly CHOP or THP-COP regimens in the treatment of newly diagnosed aggressive non-Hodgkin’s lymphoma. A comparison of doxorubicin and pirarubicin: a randomized phase II study. J Cancer ResClin Oncol, 2004, 130(2): 107-113.

1. 王彦艳, 沈志祥. 非霍奇金侵袭性B细胞淋巴瘤治疗进展. 实用医院临床杂志, 2007, 4(6): 4-5.
2. 张玉生. 吡柔比星为主的联合化疗方案治疗老年非霍奇金淋巴瘤临床研究干扰素加AVP方案与单纯AVP方案治疗多发性骨髓瘤的疗效比较. 中国医药导报, 2010, 7(4): 8-9.
3. 林晓燕, 郭学凤, 李凤菊, 等. 吡柔比星为主联合化疗方案治疗老年非霍奇金淋巴瘤临床分析. 当代医学, 2012, 18(2): 140-141.
4. 胡正操, 李永杰, 曾宪亮. 吡柔比星与阿霉素为主的方案治疗非霍奇金淋巴瘤30例疗效比较. 医学临床研究, 2011, 28(7): 1258-1262.
5. 陈小林, 赖应昌, 冯秀娟. 吡柔比星治疗非霍奇金淋巴瘤(附51例报告). 医学新知杂志, 2006, 16(6): 369-370.
6. 张之南. 血液病诊断及疗效标准. 2版. 北京: 科学出版社, 1998: 342-359.
7. 孙燕, 王少章, 刘丽影, 等. 临床肿瘤内科手册. 北京: 人民卫生出版社, 1996: 59.
8. Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. The Cochrane Collaboration, 2011. Available from www.cochranehandbook. org.
9. 倪宗赞. 医学统计学. 北京: 高等教育出版社, 2003: 241-251.
10. 闫轶鹏. 吡柔比星为主联合化疗方案治疗老年非霍奇金淋巴瘤. 中国临床实用医学. 2010, 4(2):151-152.
11. 高建湘, 周定, 王平辉, 等. 吡柔比星与阿霉素治疗非何杰金氏淋巴瘤的效果比较. 中国肿瘤临床与研究, 1999, 6(6): 63-64.
12. 崔钊, 刘小琴. 吡柔比星与阿霉素治疗非霍奇金淋巴瘤的对比观察. 肿瘤研究与临床, 2003, 15(1): 59-60.
13. 刘汉锋. 化疗辅加吡柔比星治疗老年人恶性淋巴瘤临床疗效观察. 中国肿瘤临床, 2001 28(2): 121-122.
14. 许丹丹, 吴燕明, 丁后明. 以吡柔比星为主联合化疗方案治疗非霍奇金淋巴瘤的临床观察. 吉林医学, 2011, 32(35): 7484-7485.
15. 徐聪琴, 陈善, 郑翠苹. 以吡柔比星为主联合化疗方案治疗老年非霍奇金淋巴瘤的临床观察. 现代实用医学, 2009, 2(5): 492-493.
16. 张敬东, 谢鹏鸿, 刘旭梅. 吡柔比星为主联合治疗老年非霍奇金淋巴瘤临床观察. 中国肿瘤临床与康复, 2009, 16(5): 426-427.
17. 童浩, 王继生, 秦健秀. CTOP与CHOP方案治疗老年非霍奇金淋巴瘤的临床对照研究. 临床血液学杂志, 2008, 21(7): 379-380.
18. 秦玲, 张华, 王朝刚, 等. 以吡柔比星为主联合化疗方案治疗非霍奇金淋巴瘤的临床观察. 白血病·淋巴瘤, 2008, 17(5): 381-382.
19. 王彦艳, 张晋林, 王椿, 等. CTOP与CHOP方案治疗初治侵袭性非霍奇金淋巴瘤患者疗效分析. 中华血液学杂志, 2010, 31(10): 649-653.
20. Zhai LZ, Guo CC, Cao YB, et al. Long-term results of pirarubicin versus doxorubicin in combination chemotherapy for aggressive non-Hodgkin’s lymphoma: single center, 15-year experience. Int J Hematol, 2010, 91(1): 78-86.
21. 王英娟, 綦振家, 孙晓琳. 等. 42例非霍奇金淋巴瘤性白血病临床分析. 临床荟萃. 2007, 22(22): 1637-1638.
22. 吴晓雄, 曹永彬, 刘周阳, 等. 伊立替康联合米托恩醌治疗难治/复发性非霍奇金淋巴瘤的疗效观察. 临床血液学杂志, 2009, 22(4): 366-367.
23. 贾彦焘, 贾英杰, 赵成, 等. 吡柔比星联合化疗治疗晚期肿瘤37例临床观察. 肿瘤研究与临床, 2005, 17(1): 36.
24. 佐藤靖. 吡柔比星在T细胞淋巴瘤中的内吞作用和杀细胞作用. 新药临床, 1999, 48(3): 327.
25. Tsurumi H, Yamada T, Sawada M, et al. Biweekly CHOP or THP-COP regimens in the treatment of newly diagnosed aggressive non-Hodgkin’s lymphoma. A comparison of doxorubicin and pirarubicin: a randomized phase II study. J Cancer ResClin Oncol, 2004, 130(2): 107-113.

Chinese Journal of Evidence-Based Medicine

Effectiveness and Safety of Chemotherapy Regimens Represented by Pirarubicin versus Adriamycin Hydrochloride for Non-Hodgkin Lymphoma in Mainland China: A Meta-Analysis

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