国内硼替佐米联合化疗方案治疗多发性骨髓瘤的Meta分析

Meta-analysis of Bortezomib Combined with Other Drugs for Chemotherapy in the Treatment of Multiple Myeloma

目的评价国内硼替佐米治疗多发性骨髓瘤的疗效与安全性。方法计算机检索中国知识资源总库CNKI,万方数据库,中国科技期刊数据库(重庆维普),检索年限从硼替佐米开始在中国临床应用至今(2005～2010年)。手工检索所有纳入文献的相关参考文献,筛选硼替佐米治疗多发性骨髓瘤的随机对照试验,进行资料提取后,采用STATA11软件进行Meta分析。结果共纳入7个随机对照临床试验(RCT),包括301例患者。Meta分析结果显示,硼替佐米联合化疗方案与单用MP(马法兰、泼尼松),M2(卡氮芥、环磷酰胺、长春新碱)和VAD(马法兰或长春新碱、阿霉素、地塞米松)方案比较,其治疗缓解率[RR=1.40,95%CI(1.08,1.81)]和总有效率[RR=1.29,95%CI(1.03,1.61)]差异均有统计学意义。结论目前国内的有限证据表明,与单用MP、M2或VAD方案相比,硼替佐米联合化疗方案能增加多发性骨髓瘤治疗的总有效率和缓解率,但由于纳入研究样本量小且质量较低,上述结论尚需要高质量、大样本的随机双盲对照试验加以证实。

Objective To evaluate the efficacy and safety of bortezomib combined with other drugs for chemotherapy in the treatment of multiple myeloma. Methods The CNKI,Wangfang Data,and Chinese Science and Technology Periodical Database（Chongqing VIP）were searched for literature.Retrieval period was started from bortezomib for clinical applications in China since 2005 to 2010.Manual retrieval of all relevant literature references included screening bortezomib treatment of multiple myeloma in randomized controlled trials（RCT）.STATA 11 software was used for Meta-analysis after extracting the useful data. Results A total of seven RCT were collected,including 301 cases.Meta-analysis showed that in comparison of bortezomib combined with other drugs for chemotherapy with single MP,M2,or VAD regimen,there was statistically significant difference in the response rate[RR = 1.40,95% CI（1.08,1.81）]and total effective rate[RR = 1.29,95% CI（1.03,1.61）]. Conclusion According to the limited domestic evidence,compared to single MP,M2,or VAD program,bortezomib combined with other drugs for chemotherapy in the treatment of multiple myeloma increased the overall efficiency and response rate.However,high quality,large sample,randomized,double blind controlled trials are required.