放疗联合替莫唑胺治疗术后恶性胶质瘤的Meta分析

目的比较放疗联合替莫唑胺与单纯放疗相比治疗成人恶性胶质瘤术后患者的疗效及安全性。方法检索CNKI、中国生物医学文献数据库、Pubmed、Medline、Cochrane Library、中国科技期刊数据库中的相关文献,纳入相关研究,2名研究员背对背独立提取有效数据,应用SPSS软件进行Meta分析。结果最终纳入8篇文献,包括418例患者。Meta分析结果显示:在近期疗效方面,放疗联合替莫唑胺疗法高于单纯放疗疗法,差异有统计学意义(OR=3.42,95%CI:2.09⁵.58,P<0.000 01);1年、2年、3年生存率放疗联合替莫唑胺疗法均高于单纯放疗疗法,差异均有统计学意义(1年生存率:OR=2.99,95%CI:1.855.58,P<0.000 01);1年、2年、3年生存率放疗联合替莫唑胺疗法均高于单纯放疗疗法,差异均有统计学意义(1年生存率:OR=2.99,95%CI:1.85⁴.84,P<0.000 01;2年生存率:OR=4.52,95%CI:2.554.84,P<0.000 01;2年生存率:OR=4.52,95%CI:2.55⁸.01,P<0.000 01;3年生存率:OR=4.41,95%CI:1.838.01,P<0.000 01;3年生存率:OR=4.41,95%CI:1.83¹0.64,P=0.001 0),在安全性方面,放疗联合替莫唑胺疗法不增加恶心呕吐、骨髓抑制、头晕头痛不良反应发生,P>0.05。结论恶性胶质瘤术后患者行放疗同时联合替莫唑胺口服化疗明显增加临床疗效,安全可靠,值得临床推广。

Meta-analysis of temozolomide combined with radiotherapy in treatment of postoperative malignant glioma

Objective To compare the clinical effects and safety of brain malignant glioma treated with postoperative radiotherapy combined with Temozolomide chemotherapy and with radiotherapy only. Methods By searching CNKI,CBM,Pubmed、Medline,the studies were included if they were in accordance with inclusion criteria. Data were extracted and evaluated by two reviewers independently and data were analyzed using RevMan 5. 0. Results 8studies were included with a total of 418 patients. Meta-analysis results were as follows：The total effective rate of the test group received postoperative radiotherapy combined with temozolomide chemotherapy was higher than that in the control group received radiotherapy only,the difference was statistically significant（OR = 3. 42,95% CI：2. 09 ~ 5. 58,P ＆lt; 0. 000 01）;The one-year、two-year and three-year survival rate of study group were higher than those in the control group,the difference was statistically significant（one-year survival rate：OR = 2. 99,95% CI：1. 85 ~ 4. 84,P ＆lt; 0. 00001;two-year survival rate：OR = 4. 52,95% CI：2. 55 ~ 8. 01,P ＆lt; 0. 000 01;three-year survival rate：OR = 4. 41,95% CI：1. 83 ~ 10. 64,P = 0. 001 0）;The main side-effects were nausea,vomiting,myelosuppression and headache. There were no significant diferences between the two groups,P ＆gt; 0. 05. Conclusion The clinical effects of brain malignant glioma treated with postoperative radiotherapy combined with temozolomide chemotherapy was higher than with radiotherapy only,and there were no significant adverse reactions. In that case,it is worthy to be popularized.