国内调强放疗联合替莫唑胺化疗治疗恶性脑胶质瘤疗效的Meta分析

摘要/Abstract

摘要： 目的: 系统评价调强放疗联合TMZ化疗治疗脑恶性胶质瘤的疗效及安全性,为临床治疗决策和临床研究提供参考依据。方法: 检索CNKI、CBM、VIP和万方数字化期刊全文数据库,查找国内所有有关调强放疗联合TMZ化疗与单用调强放疗治疗脑恶性胶质瘤的临床对照试验的文献,评价纳入研究质量并进行资料提取。采用RevMan 5.0.23 统计软件进行Meta分析。结果: 共纳入9篇临床对照试验文献,包括457例患者,220例患者纳入试验组,237患者纳入对照组。Meta分析结果显示:与单用调强放疗相比,调强放疗联合TMZ化疗的临床有效率[OR=3.63,95%CI(2.34,5.62)]、1年生存率[OR=2.39,95%CI(1.50,3.81)]、2年生存率[OR=2.20,95%CI(1.11,4.38)]、3年生存率[OR = 2.00,95% CI(0.81,4.94)]差异有统计学意义,调强放疗联合TMZ化疗可明显提高脑恶性胶质瘤疗效。结论: 应用调强放疗联合TMZ化疗治疗脑恶性胶质细胞瘤有效,优于单纯的放射治疗,但由于纳入的部分研究质量较低,尚需更多高质量、大样本的随机双盲对照试验进一步证实。

关键词: 脑胶质瘤, 调强放疗, 替莫唑胺, Meta分析

Abstract: AIM: To compare the clinical effects and safety of brain malignant glioma treated with postoperative IMRT combined with TMZ chemotherapy and with IMRT only, to provide reference for clinical treatment and clinical research. METHODS: By searching CNKI,CBM,VIP and Wanfang databases,the studies were included if they were in accordance with inclusion criteria. Data were extracted and evaluated, then analyzed using RevMan 5.0.23. RESULTS: 9 studies were included with a total of 457patients (220T/237C). Meta-analysis results were as follows: The total effective rate of the test group received postoperative IMRT combined with TMZ chemotherapy was higher than that in the control group received radiotherapy only,the difference was statistically significant[OR=3.63,95% CI(2.34,5.62)];The one-year、two-year and three-year survival rate of study group were higher than those in the control group,the difference was statistically significant[OR=2.39, 95%CI(1.50, 3.81)(one-year); OR=2.20, 95% CI(1.11, 4.38)(two-year); OR=2.00, 95% CI(0.81, 4.94)(three-year)]. IMRT combined TMZ can obviously improve the brain malignant glioma chemotherapy curative effect. CONCLUSION: The clinical effects of brain malignant glioma treated with postoperative IMRT combined with TMZ chemotherapy was better than with IMRT only. But due to the low quality of research, it still needs more high quality, large sample, randomized, double-blind and placebo-controlled research to confirm this conclusion.

Key words: glioma, IMRT, TMZ, Meta-analysis

中图分类号:

R311

颜元良, 钱龙, 龚志成. 国内调强放疗联合替莫唑胺化疗治疗恶性脑胶质瘤疗效的Meta分析[J]. 中国临床药理学与治疗学, 2015, 20(1): 64-69.

YAN Yuan-liang, QIAN Long, GONG Zhi-cheng. Meta-analysis of temozolomide combined with IMRT in treatment of postoperative malignant glioma in China[J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2015, 20(1): 64-69.

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