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贝伐单抗一线治疗胶质母细胞瘤的Meta分析[J]. 肿瘤防治研究, 2014, 41(10): 1098-1101. DOI: 10.3971/j.issn.1000-8578.2014.10.009
引用本文: 贝伐单抗一线治疗胶质母细胞瘤的Meta分析[J]. 肿瘤防治研究, 2014, 41(10): 1098-1101. DOI: 10.3971/j.issn.1000-8578.2014.10.009
Bevacizumab as First-line Therapy for Glioblastoma: A Meta-analysis[J]. Cancer Research on Prevention and Treatment, 2014, 41(10): 1098-1101. DOI: 10.3971/j.issn.1000-8578.2014.10.009
Citation: Bevacizumab as First-line Therapy for Glioblastoma: A Meta-analysis[J]. Cancer Research on Prevention and Treatment, 2014, 41(10): 1098-1101. DOI: 10.3971/j.issn.1000-8578.2014.10.009

贝伐单抗一线治疗胶质母细胞瘤的Meta分析

Bevacizumab as First-line Therapy for Glioblastoma: A Meta-analysis

  • 摘要: 目的 采用循证医学的方法,评价贝伐单抗一线治疗胶质母细胞瘤的疗效及安全性。方法 检索PubMed、Embase、Cochrane图书馆、中国期刊全文数据库CNKI及中国生物医学文献数据库;对符合纳入标准的文献进行数据汇总,采用Meta-Analyst Beta 3.13进行数据分析。结果 共检索到相关文献78篇,排除66篇,最终纳入12项临床试验,共计837例患者。通过Meta分析对数据进行合并,其结果显示:所有应用贝伐单抗治疗的患者6月无疾病进展生存率为84.5%(95%CI:78.1~89.3),12 月无疾病进展生存率为55.1%(95%CI:48.0~61.9),1年总生存率为76.0%(95%CI:62.5~85.7),2年总生存率为38.4%(95%CI:32.5~44.7)。经比较分析示:贝伐单抗联合RT+TMZ组与在此基础上增加其他药物组之间患者的无进展生存期和总生存期无明显差异。常见不良反应为:血小板减少、血栓/栓塞、疲劳、脑卒中、粒细胞减少、感染等,不同治疗组织之间不良反应的发生率无明显差异。结论 贝伐单抗联合标准方案治疗能够延长患者的无进展生存期,但并不能改善患者的总生存期。在贝伐单抗联合标准方案的基础上再增加其他药物治疗,未能明显改善患者的无进展生存期和总生存期。

     

    Abstract: Objective To evaluate the effect and safety of multi-drug combination with bevacizumab as a first-line therapy for glioblastoma by evidence-based medicine method. Methods Eligible literatures were collected in PubMed, Embase, The Cochrane Library, China National Knowledge Infrastructure (CNKI) and China Biology Medicine disc (CBM). MetaAnalyst Beta 3.13 was used to analyze the data. Results Seventyeight relevant studies were searched, of which 12 studies were included with a total of 837 patients involved and 66 studies were excluded. Meta-analysis showed that pooled accuracy indicators like 6-month progression-free survival(PFS-6), PFS-12, 12-month overall survival(OS-12) and OS-24 were 84.5%(95% CI:78.1-89.3), 55.1%(95% CI:48.0-61.9), 76.0%(95% CI:62.5-85.7) and 38.4%(95% CI:32.5-44.7), respectively. The difference between radiotherapy-temozolomide-bevacizumab group and more drugs group had no statistical significance in PFS or OS. The common side effects included thrombocytopenia, thrombus/embolism, fatigue, stroke, granulopenia, infection, etc. There was no significant difference between adverse effects in different treatment groups. Conclusion Bevacizumab in combination with standard chemotherapy could prolong patients' PFS, but couldn't improve OS. Moreover, it couldn't significantly improve PFS or OS to add other drugs.

     

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