早期替莫唑胺治疗在胶质母细胞瘤中应用的网状Meta分析

发布时间：2018-04-20 20:58

本文选题：胶质母细胞瘤 + 替莫唑胺　；参考：《现代预防医学》2017年20期

【摘要】：目的探索早期替莫唑胺治疗方案与标准方案在新诊断胶质母细胞瘤患者中何者方案更优。方法检索Pubmed、Cochrane、Embase、知网、万方、维普、CBM各数据库;对纳入文章进行质量评估,数据提取后采用Stata13.0进行网状Meta分析。结果所有替莫唑胺治疗方案的有效性排序从高到低分别为:早期方案、标准方案、高剂量方案、单独放疗、最后为放疗辅助替莫唑胺方案。在早期治疗方案中根据治疗剂量进行具体的有效性分析,提示早期替莫唑胺75mg/(m~2·d)连续14 d治疗剂量优于早期200 mg/(m~2·d)连续5 d治疗剂量。不良反应方面,在放疗中加入替莫唑胺治疗后整体血液毒性反应的发生率增高,然而不同类型的血液毒性反应发生率在不同干预组差异无统计学意义,主要为嗜中性粒细胞、白细胞、淋巴细胞、血小板减少和贫血,均经对症治疗后可好转,3~4级严重的血液毒性反应极少发生;最常见的非血液毒性反应为恶心、呕吐、肺炎、头痛,但本研究中所有患者在治疗前给予预防止吐剂和肺孢子虫肺炎治疗,因此,严重的非血液毒性反应也极少发生。结论本研究分析提示:在新诊断的胶质母细胞瘤患者中,早期治疗方案的疗效优于标准方案,且最佳治疗剂量为早期替莫唑胺75 mg/(m~2·d)连续14 d方案。
[Abstract]:Objective to explore the better regimen of early temozolidomide and standard regimen in newly diagnosed glioblastoma patients. Methods the databases of Pubmeda Cochraneae Embase, Zhiwang, Wanfang and Wiper were searched, and the quality of the articles was evaluated. The data were extracted and analyzed by Stata13.0. Results the order of efficacy of all temozolidomide regimens from high to low were as follows: early regimen, standard regimen, high dose regimen, radiotherapy alone, and radiotherapy plus temozolidomide regimen. According to the effective analysis of the treatment dose in the early treatment regimen, it was suggested that the early temozolidomide 75mg/(m~2 d was better than the early 200 mg/(m~2 d treatment dose for 14 days. In the side of adverse reactions, the incidence of overall blood toxicity was increased after treatment with temozolamide, but there was no significant difference in the incidence of different types of blood toxicity in different intervention groups, mainly neutrophilic granulocytes. Leukocyte, lymphocyte, thrombocytopenia and anemia, all of which can be improved after symptomatic treatment, are rarely seen in grade 3 or 4 of severe hematologic toxicity; the most common non-hematological reactions are nausea, vomiting, pneumonia, headache, and so on. However, all patients in this study were treated with prophylactic antiemetic agents and pneumocystis pneumonia before treatment. Conclusion in the newly diagnosed patients with glioblastoma, the effect of early treatment regimen is superior to that of standard regimen, and the best dose is 75 mg/(m~2 d of early temozolamide for 14 days.
【作者单位】：华北理工大学附属医院神经外科;河北省沧州市肃宁县人民医院神经外科;唐山市迁西县康力医院;华北理工大学附属医院护理部;华北理工大学附属医院重症监护病房;
【分类号】：R739.41

【相似文献】