摘要
目的：综合评价硼替佐米联合沙利度胺和地塞米松（ VTD）治疗自体造血干细胞移植（ ASCT）的多发性骨髓瘤（ MM）的有效性和安全性。方法计算机检索Pubmed、Medline、the Cochrane Library、CNKI、VIP和万方等数据库，检索时间从建库至2014年12月。纳入VTD治疗 ASCT 的MM的随机对照试验，按Cochrane系统评价的方法评价纳入研究的质量，采用Review Manager 5.3.5版软件进行Meta分析。结果共纳入5项研究，1271例患者。 Meta分析结果显示，在有效性方面，VTD的完全缓解率与接近完全缓解率（CR＋nCR）[RR＝1.50，95％CI（1.16，1.94），P＝0.002]和总有效率[RR＝1.13，95％CI（1.03，1.24），P＝0.009]优于其他联合方案，差异有统计学意义；在安全性方面，3~4度总不良反应发生率[RR＝1.29，95％CI（1.05，1.59），P＝0.02]高于其他联合方案，差异有统计学意义。结论 VTD能够显著提高ASCT的MM患者的CR＋nCR和总有效率，但总不良反应发生率增加。
Objective To evaluate the efficacy and safety of bortezomib combined with dexamethasone and thalidomide in the treatment of autologous stem cell transplantation （ ASCT） in multiple myeloma （ MM） . Methods The randomized con-trolled trials （ RCTs） on combined therapy with bortezomib,dexamethasone and thalidomide for ASCT in MM were retrieved from Pubmed,Medline,the Cochrane Library,CNKI,VIP and Wanfang databases （published until December 2014）.The method of the Cochrane systematic review was used to evaluate the quality of the included RCTs and the Review Manager 5.3.5 software was em-ployed for Meta-analysis. Results Five RCTs involving 1 271 patients were included.The meta analysis results showed that the complete remission （ CR） rate,near-CR rate and total effective rate were significantly higher after combined treatment with borte-zomib,dexamethasone and thalidomide when compared with those in other combination therapies [CR＋nCR, RR=1.50,95%CI （1.16,1.94）,P=0.002;the total effective rate,RR=1.13,95%CI （1.03,1.24）,P=0.009].In terms of safety,the grade 3/4 ad-verse events were significantly increased in the group of combined therapy with bortezomib,dexamethasone and thalidomide [ RR=1.29,95%CI （1.05,1.59）,P=0.02]. Conclusion Bortezomib combined with thalidomide and dexamethasone for the treat-ment of ASCT in MM can significantly improve the CR＋nCR and the total effective rate,but it also increases the incidence of the overall adverse events at the same time.
出处
《医药导报》
CAS
2016年第3期308-313,共6页
Herald of Medicine
