摘要
目的比较含沙利度胺(反应停)[反应停(+)]与不含反应停[反应停(-)]的化疗方案治疗多发性骨髓瘤(MM)疗效与安全性。方法采用Cochrane系统评价方法,检索《中国期刊全文数据库》、《中国优秀博硕士论文全文数据库》、《中国重要会议论文全文数据库》、《中国图书全文数据库》、《中国引文数据库》、《万方医学期刊》(1994～2010年),并手工检索所有纳入文献的参考文献,纳入沙利度胺治疗多发性骨髓瘤的随机对照试验。评价纳入研究的方法学质量并进行资料提取后,采用RevMan 4.3软件进行Meta分析。结果共鉴定并纳入7项随机对照试验研究共包括193例MM患者。目的均为比较含与不含反应停的化疗方案治疗多发性骨髓瘤的疗效和不良反应发生情况。分析结果显示,含与不含反应停的化疗方案治疗MM比较,针对降低M蛋白作用的结局指标差异有统计学意义(P<0.05),Meta分析结果显示效应统计量OR及其95%CI为3.19(1.75～5.82)。针对降低MM作用的结局指标数据差异有统计学意义(P<0.05),Meta分析结果效应统计量OR及其95%CI为3.07(1.67～5.67)。针对血红蛋白上升的结局指标差异有统计学意义(P<0.05),Meta分析结果显示效应统计量OR及其95%CI为2.96(1.58～5.54)。针对总有效率的结局指标数据差异有统计学意义(P<0.05),Meta分析结果显示效应统计量OR及其95%CI为3.54(1.83～6.81)。结论 Meta分析结果提示,对于治疗MM疗效,反应停(+)组明显优于反应停(-)组。但需要更多大样本、高质量、双盲的随机对照试验予以证实。
Objective To assess the effectiveness and safety of thalidomide for treating multiple myeloma. Methods Randomized controlled trials（RCTs） of thalidomide for multiple myeloma were collected from CHKD Data Library（1994-2010）, Wanfang Medical Journals （1994-2010）. The methodological qualities of the included studies were evaluated,and data analyses were performed using the Cochrane Collaboration＇s software RevMan 4.3. Results A total of 7 RCTs involving 193 patients were included. As for total effective rate and the effectiveness of reducing M-protein and reducing myeloma cells amounts, improving anaemia complete remission rate, significant differences were found between with or without thalidomide for the treatment of multiple myeloma（ OR = 3.54,95 % CI = 1.83 6.81; OR 3.19,95%CI = 1.75 5.82; OR =3.07,95% CI =1.67-5.67; OR =2.96,95% CI = 1.58-5.54）. Conclusion According to the domestic evidence, treatment for multiple myeloma with thalidomide can improve the total effectiveness. However, more high - quality,large-sample, randomized, double-blind, controlled trials are required.
出处
《临床荟萃》
CAS
2012年第14期1221-1225,共5页
Clinical Focus
