title: CHOP-like-14 compared to CHOP-like-21 for patients with aggressive lymphoma--a meta-analysis of randomized controlled trials.
abstract: BACKGROUND
  R-CHOP-21 has remained the standard chemotherapy for aggressive non-Hodgkin's lymphoma. It was suggested that decreasing the treatment interval from three weeks (CHOP-21) to two weeks (CHOP-14) may improve survival and disease control of patients with aggressive lymphoma.
  
  
  OBJECTIVE
  To evaluate the effect of CHOP-like-14 (with or without rituximab) compared to standard CHOP-like -21 on overall survival (OS), disease control and toxicity of patients with aggressive non-Hodgkin lymphoma.
  
  
  METHODS
  Systematic review and meta-analysis of RCTs. In October 2014 we searched The Cochrane Library, MEDLINE, LILACS, conference proceedings, and databases of ongoing trials. Authors were contacted for complementary data. The primary outcome was OS.
  
  
  RESULTS
  We identified seven trials (4073 patients), conducted between the years 1999 and 2008. Trials were at low or unclear risk for selection bias, and at low or unclear risk of attrition bias. CHOP-like-14 improved OS of patients with aggressive lymphoma compared to the same regimen given every 21 days (all trials): HR of death 0.86, 95% confidence interval (CI) 0.77-0.97. There was no OS difference between rituximab-CHOP-like 14 to rituximab-CHOP-like-21 (3 trials): HR 0.93 95% CI 0.78-1.10. The rates of progression or death, complete response, treatment-related mortality, grade 3-4 infection, and discontinuation were similar between groups.
  
  
  CONCLUSIONS
  R-CHOP-21 remains the standard of care for patient with aggressive B-cell lymphoma. CHOP-14 can be considered as in case rituximab is omitted.
authors.affiliation: a Institute of Hematology, Beilinson Hospital, Rabin Medical Center , Petah Tikva , Israel.|b Tel Aviv University, Sackler Faculty of Medicine , Israel.
authors.forename: Liat
authors.initials: L
authors.lastname: Vidal
authors.affiliation: b Tel Aviv University, Sackler Faculty of Medicine , Israel.|c Department of Hematology , Assuta Medical Centers , Tel-Aviv , Israel.
authors.forename: Ofer
authors.initials: O
authors.lastname: Shpilberg
authors.affiliation: a Institute of Hematology, Beilinson Hospital, Rabin Medical Center , Petah Tikva , Israel.|b Tel Aviv University, Sackler Faculty of Medicine , Israel.
authors.forename: Ronit
authors.initials: R
authors.lastname: Gurion
authors.affiliation: d Cochrane Haematological Malignancies Group, Department I of Internal Medicine , University Hospital of Cologne , Germany.
authors.forename: Ina
authors.initials: I
authors.lastname: Monsef
authors.affiliation: a Institute of Hematology, Beilinson Hospital, Rabin Medical Center , Petah Tikva , Israel.|b Tel Aviv University, Sackler Faculty of Medicine , Israel.
authors.forename: Pia
authors.initials: P
authors.lastname: Raanani
authors.affiliation: b Tel Aviv University, Sackler Faculty of Medicine , Israel.|e Bone Marrow Transplantation Unit, Sourasky Medical Center , Tel Aviv , Israel.
authors.forename: Ron
authors.initials: R
authors.lastname: Ram
authors.affiliation: a Institute of Hematology, Beilinson Hospital, Rabin Medical Center , Petah Tikva , Israel.|b Tel Aviv University, Sackler Faculty of Medicine , Israel.|f Department of Medicine A , Beilinson Hospital, Rabin Medical Center , Petah Tikva , Israel.
authors.forename: Anat
authors.initials: A
authors.lastname: Gafter-Gvili
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use*; D003520:Cyclophosphamide / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage; D004334:Drug Administration Schedule; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000188:drug therapy* / Q000401:mortality; D008875:Middle Aged; D011241:Prednisone / Q000008:administration & dosage; D016032:Randomized Controlled Trials as Topic; D000069283:Rituximab / Q000008:administration & dosage; D014750:Vincristine / Q000008:administration & dosage
chemical_list: D000069283:Rituximab; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011241:Prednisone