高剂量强度环磷酰胺治疗非霍奇金淋巴瘤的Meta分析  

High dose intensity Cyclophosphamide in aggressive non-Hodgkin's lymphoma:a literature-based Meta-analysis

作　　者：刘福[1] 何梅[1] 李胜前[1] 周玥[1] 赵曜[1] 杨明[1] 

机构地区：[1]川北医学院附属医院药剂科,四川南充637000

出　　处：《中华肿瘤防治杂志》2015年第11期891-896,共6页Chinese Journal of Cancer Prevention and Treatment

基　　金："十二五"国家科技支撑计划(2013BAI06B04)

摘　　要：目的评价高剂量强度环磷酰胺治疗非霍奇金淋巴瘤的疗效。方法计算机检索PubMed、Medline、Embase、Cochrane图书馆、CBM、VIP和CNKI数据库,检索时间至2013-12。纳入以CHOP（环磷酰胺、多柔比星、长春新碱、泼尼松）化疗方案为对照组,且试验组加用环磷酰胺〔剂量强度〉250mg/（m2·周）〕的相关研究,评价纳入研究的方法学质量,并提取资料,用Stata 11.0软件对数据进行Meta分析。结果共纳入9篇随机对照试验,3 509例患者。Meta分析显示,高剂量强度环磷酰胺的方案较标准CHOP的5年总生存率（SHR=0.83,95%CI为0.73~0.94）、5年无事件生存率（SHR=0.80,95%CI为0.72~0.89）、完全缓解率（SOR=0.70,95%CI为0.63~0.77）,差异均有统计学意义（P值均〈0.05）,此获益在中高危或预后差的非霍奇金淋巴瘤患者中更加显著。结论高剂量强度环磷酰胺联合CHOP方案较CHOP方案可改善非霍奇金淋巴瘤患者的5年总生存率、5年无事件生存率及完全缓解率,该方案适用于中高危或预后差的非霍奇金淋巴瘤患者,但尚需更多大样本高质量随机对照试验进一步确认。OBJECTIVE To evaluate the efficacy of dose-intensified cyclophosphamide in the treatment of Non Hodgkin＇s lymphoma.METHODS Data were searched in PubMed,Medline,Embase,Cochrane Library,CBM,VIP,CNKI databases（up to December）.Eligible trials had CHOP（cyclophosphamide,doxorubicin,vincristine,prednisone）as control arm and any regimen administering cyclophosphamide at a higher dose intensity〔250mg/（m2·week）〕as the investigational arm.Methodology of eligible was assessed and relevant data were extracted.Meta-analysis was conducted with Stata 11.0software.RESULTS Nine trials involved with 3 509 participants were eligible.Patients receiving high dose intensity-based cyclophosphamide had a significantly better 5year-overall survival（SHR=0.83,95%CI：0.73-0.94）,5year-event-free survival（SHR=0.80,95%CI：0.72-0.89）and complete response rate（SOR=0.70,95%CI：0.63-0.77）.CONCLUSION Dose-intensified cyclophosphamide regimen has significant benefit on 5-year-overall survival,5year-event-free survival and complete response,this benefit is more prominent in intermediate＋high-risk nonHodgkin＇s lymphoma,but more large sample and high quality randomized controll trials are needed.

关 键 词：环磷酰胺 剂量强度 非霍奇金淋巴瘤 META分析 

分 类 号：R733.1[医药卫生—肿瘤]