R-CHOP方案治疗B细胞非霍奇金淋巴瘤与CHOP方案对比的Meta分析

王建华

摘要：目的  以Meta分析的方法來评价利妥昔单抗联合CHOP方案治疗B细胞性非霍奇金淋巴瘤的疗效。方法  计算机检索维普数据库、中国知网、万方数据库、pubmed数据库等，检索利妥昔单抗联合化疗治疗B细胞性非霍奇金淋巴瘤的随机对照试验，并手工检索相关会议记录及纸质文献，应用国际Cochrane协作网的系统评价方法对所得数据进行质量评分，进行资料提取后，采用RevMan5.3软件进行Meta分析。结果  共检索到14个随机对照试验，共包括2433例患者，异质性检验P>0.1，基线具有可比性，选择固定效应模型分析所得结果显示R-CHOP方案化疗组的完全缓解率高于单纯CHOP化疗组（RR=1.3，95%CI为1.3～1.41），差异有统计学意义（P<0.05）;R-CHOP方案总有效率高于CHOP组（RR=1.32，95%CI为1.22～1.42），差异有统计学意义（P<0.05）;其不良反应与对照组比较，差异无统计学意义（P>0.05）。结论  R-CHOP方案相对CHOP方案治疗B细胞性非霍奇金淋巴瘤来说具有更高的完全缓解率和总有效率，进一步证明其治疗效果需开展更多的随机对照试验。

关键词：B细胞性非霍奇金淋巴瘤;利妥昔单抗;随机对照试验

中图分类号：R551.2                                 文献标识码：A                                 DOI：10.3969/j.issn.1006-1959.2019.10.027

文章编号：1006-1959（2019）10-0081-04

Abstract：Objective  To evaluate the efficacy of rituximab combined with CHOP regimen in the treatment of B-cell non-Hodgkin's lymphoma by meta-analysis.Methods  A computer-based search of the Vip database， China Knowledge Network， Wanfang database， pubmed database， etc.， search for randomized controlled trials of rituximab combined with chemotherapy for B-cell non-Hodgkin's lymphoma， and manually retrieve relevant meeting minutes and paper In the literature， the systematic evaluation method of the international Cochrane Collaboration Network was used to score the quality of the data，after data extraction， Meta analysis was performed using RevMan5.3 software.Results  A total of 14 randomized controlled trials were included， including a total of 2，433 patients. The heterogeneity test was P>0.1， and the baseline was comparable. The results of the selected fixed-effects model showed that the complete response rate of the R-CHOP regimen was higher than that of CHOP alone. The chemotherapy group （RR=1.3， 95% CI 1.3～1.41）， the difference was statistically significant （P<0.05）; the total effective rate of R-CHOP regimen was higher than that of CHOP group （RR=1.32， 95% CI was 1.22～1.42），the difference was statistically significant（P<0.05）; the adverse reactions were not significantly different from the control group（P>0.05）.Conclusion  The R-CHOP regimen has a higher complete response rate and total effective rate than the CHOP regimen in the treatment of B-cell non-Hodgkin's lymphoma.It is further proved that the therapeutic effect requires more randomized controlled trials.