摘要
目的探讨多发性骨髓瘤患者行沙利度胺联合VAD方案(长春新碱+表柔比星+地塞米松)治疗的临床疗效和安全性。方法以沙利度胺联合VAD方案作为试验组,以单用VAD方案作为对照组。通过计算机检索中国知网、万方数据库、维普数据库,并进一步对纳入文献的参考文献进行扩大检索。对符合纳入标准的随机对照研究(RCT)进行资料提取、质量评价后,采用Stata14.0软件进行Meta分析。结果共纳入17项研究940例患者。试验组较对照组有着更高的总有效率,二组差异有统计学意义(RR=1.41,95% CI 1.30~1.59,P<0.01)。试验组在改善血红蛋白及降低β2微球蛋白(β2-MG)、M蛋白、骨髓瘤细胞方面较对照组有更好的效果。但试验组有更严重的胃肠道反应,两组差异有统计学意义(RR=1.36,95% CI 1.04~1.78,P=0.024)。结论沙利度胺联合VAD方案比单用VAD方案治疗多发性骨髓瘤有更好的临床疗效,但也存在更严重的不良反应。
Objective To analyze the clinical efficacy and safety of thalidomide combined with VAD regimen (vincristine + epirubicin + dexamethasone) or VAD regimen alone in treatment of multiple myeloma (MM) by using meta-analysis. Methods Thalidomide combined with VAD regimen was selected as the experimental group and VAD regimen alone was selected as the control group. The literatures were searched from CNKI, Wanfang and VIP database. And then the inclusive literatures were further searched. Randomized controlled trials eligible to the exclusive criteria were extracted, and the quality was evaluated. Meta-analysis was conducted by using Stata14.0 software. Results A total of 17 studies and 940 patients were included. The experimental group had a higher total effective rate compared with the control group, and the difference was statistically significant (RR = 1.41, 95% CI 1.30-1.59, P < 0.01). Meanwhile, the experimental group had a better efficacy in improving hemoglobin and deducing β-macroglobulin (MG), M protein and myeloma cells compared with the control group;however, the experimental group also had a worse gastrointestinal reaction, and the difference was statistically significant (RR = 1.36, 95% CI 1.04-1.78, P = 0.024). Conclusion Thalidomide combined with VAD regimen in treatment of MM has a better clinical efficacy compared with VAD regimen alone, but it also has a worse adverse reaction.
作者
刘飞飞
王彦
林小云
沈建箴
Liu Feifei;Wang Yan;Lin Xiaoyun;Shen Jianzhen(Department of Hematology, Fujian Institute of Hematology, Fujian Provincial Key Laboratory on Hematology, Fujian Medical University Union Hospital, Fuzhou 350001, China)
出处
《白血病．淋巴瘤》
CAS
2019年第5期281-287,共7页
Journal of Leukemia & Lymphoma
基金
福建省环保科技厅创新项目(2015R011)
福建省医学创新项目(2017-CX-16)
高效产学研合作项目(2018Y4004)
福建省血液医学中心资助项目(2011702#).
