【作者】 朱珂；

【导师】 刘卓刚；

【作者基本信息】 中国医科大学 ， 内科学， 2010， 硕士

【摘要】 目的系统评价大剂量化疗后自体干细胞移植一线治疗滤泡性淋巴瘤的临床疗效与安全性。方法计算机检索MEDLINE数据库(1990-2009)、EMBASE数据库(1990-2009)、OVID数据库(1990-2009)、Cochrane图书馆(2009年第2期),手工检索美国血液年会(ASH)会议记录及相关文献的参考文献,评价纳入研究的方法学质量,采用STATA10.0软件和RevMan4.3软件进行统计分析。结果共纳入4个随机对照试验,包括941例患者。Meta分析的结果显示,大剂量化疗后自体干细胞移植一线治疗滤泡性淋巴瘤与常规化疗相比,总生存率HR0.82,95%CI[0.49,1.15]；无事件生存率HR 0.35,95%CI[0.24,0.47]；总缓解率RR 0.35,95%CI[0.96,1.30]；继发恶性肿瘤发生率RR 1.68,95%CI[0.47,6.07]。结论现有证据表明,大剂量化疗后自体干细胞移植一线治疗滤泡性淋巴瘤与常规化疗相比,不改善患者的总生存率及总缓解率,但能提高无事件生存率,不增加继发恶性肿瘤发生的风险。本研究纳入的病例数较少,结论尚需高质量多中心大样本随机对照试验证实。更多还原

【Abstract】 ObjectiveTo assess the effectiveness and safety of high-dose chemotherapy following autologous stem cell transplantation in first-line treatment of follicular lymphoma.MethodsRandomized controlled trials (RCTs) of high-dose chemotherapy following autologous stem cell transplantation in first-line treatment of follicular lymphoma were collected from MEDLINE database(1990-2009),EMBASE database (1990-2009), OVID database (1990-2009), and the Cochrane Library(Issue2,2009). Meeting reports of ASH were hand searched. The methodological quality of included studies was evaluated, and data analyses were performed using software STATA 10.0 and Revman 4.3.ResultsA total of 4 RCTs involving 941 patients were included. The results of meta-analyses showed that HR of overall survival is 0.82,95%CI[0.49,1.15]; HR of event free survival is 0.35,95%CI[0.24,0.47]; RR of total remission rate is 0.35, 95%CI[0.96,1.30];RR of secondary cancers incidence rate is 1.68,95%CI[0.47,6.07].ConclusionsAccording to the present evidence, high-dose chemotherapy following autologous stem cell transplantation can not improve overall survival and total remission rate, but can improve event free survival, and do not increase the secondary cancers incidence rate. However, more high-quality, multiple-center, large-sample randomized controlled trials are required.更多还原