摘要
目的:评价硼替佐米联合不同化疗药物治疗多发性骨髓瘤的疗效与安全性。方法:计算机检索Pub Med数据库,Cochrane图书馆临床对照试验数据库,中国期刊全文数据库和中国生物医学文献数据库,进一步对纳入文献的参考文献进行扩大搜索。采用Rev Man 5.3软件进行Meta分析。结果:共纳入8篇文献,包括1 627例患者。Meta分析显示硼替佐米联合地塞米松和沙利度胺(BTD)组较硼替佐米联合地塞米松(BD)组缓解率好[OR=1.70,95%CI(1.18,2.44),P=0.005],感染率[OR=1.19,95%CI(0.73,1.94),P=0.48]和3-4级血小板减少率[OR=2.17,95%CI(0.91,5.19),P=0.08]无统计学差异。硼替佐米联合地塞米松和阿霉素(BAD)组较BD组缓解率高[OR=3.79,95%CI(1.28,11.22),P=0.01]。BTD组和硼替佐米联合马法兰和泼尼松(BMP)组缓解率无统计学差异[OR=1.42,95%CI(0.96,2.09),P=0.08]。3-4级不良事件发生率无统计学差异[OR=1.55,95%CI(0.61,3.90),P=0.35]。BAD组和硼替佐米联合地塞米松和环磷酰胺(BCD)组缓解率无统计学差异[OR=0.99,95%CI(0.61,1.59),P=0.96],BCD组疗效好于BAD组。结论:硼替佐米三药联合较硼替佐米二药联合效果好,毒副反应基本相同。不同的三药联合方案效果也不同,在BTD、BAD、BCD、BMP这几个方案中,BCD效果最好。
Objective To assess the effectiveness and safety of bortezomib combined with different chemotherapeu- tics for treating multiple myeloma. Methods : Data were searched from P ubM ed, Cochrane central Register of Con-trolled Trials( CENTRAL) of The Cochrane Library China National Knowledge Infrastructure( CNKI) and China Biol-ogy Medicine( CBM) . Data analysis was performed with RevMan 5.3. Results: A total of 8 articles in volvin g 1 627 pa-tients were included. Meta - analysis results showed BTD was better than BD about OR[ OR = 1.80,95% CI( 1.25 ,2. 61) yP = 0. 002] ,and the infection rate[ OR = 1. 19 ,95% CI ( 0. 73,1.94 ) yP = 0 . 48 ] and 3 and 4 grade thrombo-cytopenia [ OR = 2.17,95 % Cl (0. 91,5.19),P=0. 08] had no significant differences. BAD was better than BD about OR[ OR = 3. 79,95% CI( 1.28,11.22) = 0. 01 ]. BTD and BMP had no significant differences about OR [ OR =1.42,95% Cl(0. 96,2. 09) = 0. 08 ] and 3 and 4 grade adverse events had no significant differences[ OR = 1.55 ,95% CI(0. 61,3.90) ,P = 0. 35 ]. BCD and BAD had no significant differences about OR[ OR = 0. 99 ,95% Cl (0. 61,1.59) ,P =0.96] ,but BCD has better effect than BAD. Conclusion: Bortezomib plus two drugs is better than borte-zomib plus one drugs and the side effect had no significant differences. The different plan about bortezomib plus two drugs have different effect,BCD is the best about BTD,BAD,BCD,BMP.
出处
《现代肿瘤医学》
CAS
2016年第21期3469-3475,共7页
Journal of Modern Oncology