Jiang Yanxia, Chen Yan, Huang Ruibin, Chen Guoan
Hematology Department, The 1st Affiliated Hospital of Nanchang University, No. 17 Yongwaizheng Street, Donghu District, Nanchang, 33000, Jiangxi, China.
Int J Hematol. 2016 Oct;104(4):413-9. doi: 10.1007/s12185-016-2080-5. Epub 2016 Aug 16.
To compare the efficiency of doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) against that of bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone (BEACOPP) for treating Hodgkin lymphoma (HL). An extensive English-language literature retrieval on clinical outcomes after treatment by ABVD versus BEACOPP was conducted on Medline, PubMed, and Embase through the period ending December 2015. Odds ratio (OR) with corresponding 95 % confidence interval (95 % CI) was pooled based on the heterogeneity across individual studies. In total, seven articles reporting on four trials were included in this meta-analysis. Patients assigned to BEACOPP therapy had a better complete remission (CR) rate (OR = 0.55, 95 % CI 0.35, 0.87), overall survival (OS) greater than 5 years (OR = 0.64, 95 % CI 0.51, 0.81), and progression-free survival (PFS, OR = 0.56, 95 % CI 0.38, 0.81) than patients assigned to ABVD therapy. Subgroup analysis stratified using a different strategy showed no significant difference for OS between short courses of escalated BEACOPP combined with standard BEACOPP and that for ABVD (OR = 0. 72, 95 % CI 0. 45, 1.15). Reduced progression/relapse, better CR, and similar OS were observed with BEACOPP, indicating its superior efficiency of BEACOPP in the treatment of HL. However, more analysis of treatment-related toxicity is needed.
比较多柔比星、博来霉素、长春碱和达卡巴嗪(ABVD)方案与博来霉素、依托泊苷、多柔比星、环磷酰胺、长春新碱、丙卡巴肼和泼尼松(BEACOPP)方案治疗霍奇金淋巴瘤(HL)的疗效。截至2015年12月,通过检索Medline、PubMed和Embase数据库,对ABVD方案与BEACOPP方案治疗后的临床结局进行了广泛的英文文献检索。根据各研究间的异质性,汇总了比值比(OR)及相应的95%置信区间(95%CI)。本荟萃分析共纳入7篇报道4项试验的文章。与接受ABVD方案治疗的患者相比,接受BEACOPP方案治疗的患者完全缓解(CR)率更高(OR = 0.55,95%CI 0.35,0.87),5年以上总生存期(OS)更长(OR = 0.64,95%CI 0.51,0.81),无进展生存期(PFS,OR = 0.56,95%CI 0.38,0.81)。采用不同策略进行分层的亚组分析显示,短疗程强化BEACOPP联合标准BEACOPP方案与ABVD方案相比,OS无显著差异(OR = 0.72,95%CI 0.45,1.15)。BEACOPP方案可降低进展/复发率,提高CR率,且OS相似,表明其在HL治疗中疗效更优。然而,还需要对治疗相关毒性进行更多分析。