Comparison of CHOP vs CHOPE for treatment of peripheral T-cell lymphoma: a meta-analysis

Objective: To compare cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) and CHOP plus etoposide (CHOPE) with regard to outcomes including efficacy and safety for patients with peripheral T-cell lymphoma (PTCL). Methods: Relevant literature was searched using PubMed, Embase, Wanfang, and CNKI for eligible trials comparing CHOP with CHOPE for treatment of PTCL. The following outcomes of PTCL patients were considered: complete response (CR), partial response (PR), overall response rate (ORR), and adverse events (AEs; grade >= 3). Risk ratios (RRs) were appropriately derived from fixed-effects or random-effects models. Results: A total of five prospective or retrospective articles with 1,560 patients were elected for the meta-analysis. There were no significant differences in CR (RR=1.11, 95% CI: 0.73-1.67, P=0.632), PR (R =1.40, 95% CI: 0.52-3.76, P=0.504), and ORR (RR=1.25, 95% CI: 0.93-1.69, P=0.146) between the CHOP and CHOPE groups. However, AEs including anemia (RR=1.69, 95% CI: 1.33-2.16, P<0.001)and thrombocytopenia (RR=1.43, 95% CI: 1.15- 1.77, P=0.001) were significantly increased in CHOPE group compared to that in CHOP group. Conclusion: Meta-analysis suggested that there were no differences in therapeutic effect for patients with PTCL between CHOP and CHOPE groups with regards to CR, PR, and ORR, whereas the CHOPE group had significantly increased AEs (anemia and thrombocytopenia) compared to CHOP group.