间变性胶质瘤术后辅助治疗的系统评价

发布时间：2018-05-27 03:36

本文选题：间变性胶质细胞瘤 + WHOⅢ级　；参考：《中南大学》2014年硕士论文

【摘要】：目的：评价间变性胶质细胞瘤术后联合放化疗对比单独放疗总生存时间和无进展生存期是否提高。方法：计算机检索Medline (PubMed)、Embase和Cochrane L ibrary以及CNKI中文数据库中2001年1月至2013年1月研究间变性胶质瘤术后放化疗联合治疗对比单独放疗的文献,评价纳入文献的质量并进行资料提取后,采用stata12.0软件进行Meta分析。本次纳入的文献符合以下标准：1.必须是联合放化疗对比单独放疗的随机对照临床试验。2.试验对比的是病人的总生存时间和／或无进展生存期。3.病理诊断为间变性胶质瘤。结果：共纳入4个RCT,总共963个病人。Meta分析结果显示：与单纯术后放疗相比,术后联合放化疗总生存时间有显著性提高(HR=0.84,95%CI0.72-0.98, P=0.031),无进展生存期也有显著性提高(HR=0.68,95%CI0.57--0.80, p=0.000)。亚组分析显示：AA组术后放化疗联合治疗与术后单独放疗相比,总生存时间没有显著性差异(HR=0.79,95%CI0.61-1.02, p=0.072), AO/AOA组的结果与AA组相似(](HR=0.87,95%CI0.71-1.07, p=0.183)。伴有lp/19q染色体杂合子缺失的患者与不伴有lp/19q缺失的患者相比,总生存时间有显著性提高(](HR=0.299,95%CI0.207-0.433, P=0.000)。结论：通过本次meta分析表明,间变性胶质瘤的辅助化疗在治疗方案中扮演了有益的角色,联合放化疗可以提高患者的总生存时间和无进展生存期,但伴随较大的毒副反应；伴有lp/19q染色体杂合子缺失的患者对化疗更敏感,是间变性胶质瘤有利的预后因素。
[Abstract]:Objective: to evaluate the improvement of total survival time and progression free survival in patients with anaplastic glioma after surgery combined with radiotherapy and chemotherapy alone. Methods: the literatures of Medline pubMedus Embase and Cochrane L ibrary and CNKI Chinese database from January 2001 to January 2013 were searched and compared with radiotherapy alone. The quality of the literature was evaluated and the data were extracted. Meta analysis was carried out with stata12.0 software. The literature included this time meets the following criteria: 1. 1. Must be combined with radiotherapy versus radiotherapy alone in randomized controlled clinical trial. 2. The trial compared the patient's total survival time and / or progression-free survival of 3. 3. The pathological diagnosis was anaplastic glioma. Results: a total of 963 patients. Meta-analysis showed that compared with postoperative radiotherapy alone, the total survival time of postoperative combined radiotherapy and chemotherapy was significantly improved by HR0.84% 95% CI 0.72-0.98, P < 0.031%, and the progression-free survival time was also significantly increased by 0.6895CI 0.57- 0.80, p0.000 ~ 0.000. The results of subgroup analysis showed that there was no significant difference in total survival time between the two groups compared with radiotherapy alone. The results of AO/AOA group were similar to those of AA group (P 0.183). Compared with those without lp/19q deletion, the total survival time of patients with lp/19q heterozygote deletion was significantly increased (P < 0.29995 CI 0.207-0.433, P = 0.000). Conclusion: the meta analysis shows that adjuvant chemotherapy plays a beneficial role in the treatment of anaplastic glioma. Combined radiotherapy and chemotherapy can improve the total survival time and progression free survival of the patients, but with a large toxicity. Patients with lp/19q heterozygote deletion are more sensitive to chemotherapy and are favorable prognostic factors for anaplastic glioma.
【学位授予单位】：中南大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R739.4

【参考文献】