Five RCTs (n=641 patients) were included in the review. Sample sizes ranged from 45 to 318. Three of the studies were phase III RCTs and two were phase II RCTs. The quality scores were 7 points in two studies, 6 points in two studies and 5 points in one study.
There was no significant difference between ICHP and control chemotherapy in objective response rate (OR 1.29, 95% CI 0.87 to 1.93; four RCTs). No evidence of statistical heterogeneity was found (I2=39.9%, p=0.17). No evidence of publication bias was found (funnel plots showed symmetry, Egger test p=0.83).
When compared to control chemotherapy, ICHP was not associated with any improvement in overall survival (HR 0.94, 95% CI 0.80 to 1.10; four RCTs). No evidence of heterogeneity was found (I2=48.7%, p=0.12).
When compared to control chemotherapy, ICHP was associated with a higher incidence of grade 3 and 4 hemoglobin nadir (OR 3.71, 95% CI 2.56 to 5.39; three RCTs) and platelet nadir (OR 4.9, 95% CI 3.15 to 7.63; four RCTs). No effect was found on leukocyte nadirs (OR 1.52, 95% CI 0.90 to 2.56; three RCTs).