摘要
目的:系统评价术后辅助化疗对成人脑恶性胶质瘤的临床疗效及安全性。方法:计算机检索PubMed、Cochrane Library、EMBASE、中国期刊全文数据库、中国生物医学文献数据库、中文科技期刊全文数据库,并辅手工和其他检索,搜集国内外术后辅助化疗治疗成人脑恶性胶质瘤的随机对照试验。由2名评价员独立筛选文献和提取资料,并对其方法学质量进行评价,采用RevMan 5.0软件进行统计分析。结果:共纳入13个随机对照试验(3 639例患者),Meta分析结果显示:与术后单纯放疗相比,术后辅助化疗可提高1～2年生存率和2年无疾病进展生存率,其OR和95%CI,分别为0.61(0.43,0.87),0.52(0.33,0.81),0.42(0.19,0.90);对1年无疾病进展生存率和5年生存率差异无显著性,其OR和95%CI,分别为0.52(0.26,1.04),0.75(0.54,1.04)。5个研究(2 418例)报告了患者在治疗期间发生的不良反应,术后辅助化疗不良反应发生率较术后单纯放疗高。结论:恶性胶质瘤患者术后采取辅助化疗措施可以提高其1和2年生存率,尤其是1年生存率,对于提高2年和5年无疾病进展生存率可能有价值。由于纳入文献质量的原因,尚需进一步开展高质量的随机对照试验,验证其疗效与安全性。
Objective： To evaluate the effects and safety of adjuvant chemotherapy for adults with malignant glioma. Method： PubMed, EMBASE, Coehrane Library, CNKI, Chinese Biomedical Database and VIP were reviewed and randomized controlled trials of adjuvant chemotherapy for adults with malignant glioma were identified. The quality of the ineluded trials was evaluated by two reviewers. A recta-analysis was conducted in homogeneous studies. Result： 13 controlled trials were involved in 3639 patients. The rectanalysis results showed that compared with radiotherapy alone, the adjuvant chemotherapy might increase 1 year survival , 2 years survival, 2 years progression free survival, and their OR and 95% CI were 0.61 （0.43, 0.87）, 0.52（0.33, 0.81 ）, and 0.42（0.19, 0.90）, respectively, but 1 year progression free survival and 5 years survival had no statistical significanee. Their OR and 95 % CI were 0.52 （0.26, 1.04 ） and 0.75 （0.54, 1.04） respectively. 5 studies （2418 cases） reported that the toxicity rates increased in patients who received radiotherapy plus adjuvant chemotherapy compared with those in patients who received radiotherapy alone. Conclusion： The adjuvant chemotherapy may increase one year survival and two years survival, and have advandage impact on 2 years and 5 years progression free survival. Owing to the high possibility of attrition bias and measurement bias in the included studies, there must be a negative impact on evidence intensity of our results and therefore, some randomized controlled trials with high quality have to be expected to obtain the best evidence.
出处
《药物流行病学杂志》
CAS
2009年第4期236-241,共6页
Chinese Journal of Pharmacoepidemiology
