中国循证医学杂志

中国循证医学杂志

贝伐单抗联合 STUPP 方案治疗新诊断胶质瘤有效性和安全性的 Meta 分析

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目的系统评价贝伐单抗联合 STUPP 方案治疗新诊断胶质瘤患者的有效性与安全性。方法计算机检索 PubMed、EMbase、The Cochrane Library、CBM、CNKI、VIP 和 WanFang Data 数据库,搜集贝伐单抗联合 STUPP 方案治疗新诊断恶性胶质瘤患者的随机对照试验(RCTs),检索时限均从建库至 2017 年 9 月。由 2 位评价员独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用 RevMan 5.3 软件进行 Meta 分析。结果共纳入 6 个 RCTs,合计 2 835 例患者。Meta 分析结果显示:与对照组相比,贝伐单抗联合 STUPP 方案组 PFS 明显延长[HR=0.69,95%CI(0.62,0.77),P<0.000 01]。但贝伐单抗联合 STUPP 方案组的三级及三级以上不良反应发生率明显高于对照组,差异有统计学意义(P<0.05)。结论当前证据表明,贝伐单抗联合 STUPP 方案在治疗新诊断胶质瘤患者相比单用 STUPP 方案可延长 PFS,但易出现更多的不良反应。受纳入研究质量和数量限制,上述结论有待更多高质量的 RCTs 进一步验证。

ObjectivesTo systematically review the efficacy and safety of bevacizumab combined with STUPP regimen for newly diagnosed glioblastoma.MethodsPubMed, EMbase, the Cochrane Library, CBM, CNKI, VIP and WanFang Data databases were searched to obtain randomized controlled trials (RCTs) of bevacizumab combined with STUPP regimen for newly diagnosed glioblastoma patients from inception to September 2017. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Meta-analysis was then performed using RevMan 5.3 software.ResultsA total of 6 RCTs involving 2 835 patients were included. The results of meta-analysis showed that: the bevacizumab combined with STUPP regimen group was superior to the control group on PFS (HR=0.69, 95%CI 0.62 to 0.77, P<0.000 01). But the adverse events rate at the three and above three levels was significantly higher than the control group (P<0.05).ConclusionsCurrent evidence shows that bevacizumab combined with STUPP regimen for newly diagnosed glioblastoma can significantly prolong the PFS. The treatment group performs not as well as the control group on adverse event rate. Due to the limited quality and quantity of the included studies, more high-quality studies are required to verify above conclusions.

关键词: 贝伐单抗; STUPP 方案; 胶质瘤; 随机对照试验; Meta 分析; 系统评价

Key words: Bevacizumab; STUPP regimen; Glioblastoma; Randomized controlled trials; Meta-analysis; Systematic review

引用本文: 陈昭燕, 田方圆, 占美, 徐珽. 贝伐单抗联合 STUPP 方案治疗新诊断胶质瘤有效性和安全性的 Meta 分析. 中国循证医学杂志, 2018, 18(5): 470-475. doi: 10.7507/1672-2531.201710122 复制

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