利妥昔单抗治疗新诊断原发性中枢神经系统淋巴瘤的系统回顾和荟萃分析  

Systematic review and meta-analysis of rituximab in the treatment of primary central nervous system lymphoma

作　　者：郭怀鹏 秦炜炜 郭欢绪 范丹 张启科[2] GUO Huaipeng;QIN Weiwei;GUO Huanxu;FAN Dan;ZHANG Qike(Department of Hematology,Second Affiliated Hospital of Air Force Medical University,Xi'an,Shaanxi 710083,China;Department of Hematology,Gansu Provincial People's Hospital,Lanzhou,Gansu 730013,China)

机构地区：[1]中国人民解放军空军军医大学血液内科,陕西西安710083 [2]甘肃省人民医院血液内科,甘肃兰州730013

出　　处：《检验医学与临床》2022年第15期2086-2090,共5页Laboratory Medicine and Clinic

摘　　要：目的系统评价利妥昔单抗治疗新诊断原发性中枢神经系统淋巴瘤(PCNSL)的疗效和安全性,为新诊断PCNSL探索新的治疗方案。方法计算机检索PubMed、Embase、Cochrane Library、OVID、Web of Science、CNKI、Wanfang等电子数据库,检索时限为从建库至2021年8月。收集利妥昔单抗对比其他疗法治疗新诊断PCNSL的随机对照试验。由两名研究者按照Cochrane手册推荐的系统评价方法,分别进行资料提取、质量评价,并交叉核对,使用RevMan 5.3软件进行Meta分析。结果共纳入6项研究,均为随机对照试验,中文文献5篇,英文文献1篇,共666例新诊断PCNSL患者。Meta分析结果显示,利妥昔单抗组较非利妥昔单抗组治疗新诊断PCNSL,完全缓解率、部分缓解率、2年生存率、3年生存率均明显提高(P<0.05),胃肠道反应、神经毒性、口腔炎发生率较低(P<0.05),血液毒性发生率差异均无统计学意义(P>0.05)。结论对于新诊断PCNSL,利妥昔单抗的加入可提高PCNSL患者的缓解率、生存率,不良反应发生率较低,值得临床推广。Objective To systematically review the efficacy and safety of rituximab in the treatment of newly diagnosed primary central nervous system lymphoma(PCNSL),and explore a new treatment scheme for newly diagnosed PCNSL.Methods PubMed,Embase,Cochrane Library,OVID,Web of Science,CNKI,Wanfang and other electronic databases were searched by computer.The retrieval time limit was from the establishment of the database to August 2021.Randomized controlled trials of rituximab versus other therapies in the treatment of newly diagnosed PCNSL were collected.According to the systematic evaluation method recommended by Cochrane manual,two researchers conducted data extraction,quality evaluation,cross check,and meta-analysis using Revman 5.3 software.Results A total of 6 studies were included,and all of these were randomized controlled trials,including 5 literatures in Chinese and 1 literature in English,involving 666 patients with PCNSL.The results of meta-analysis showed that,compared with non rituximab group,the complete remission rate,partial remission rate,2-year survival rate and 3-year survival rate of newly diagnosed PCNSL in rituximab group were significantly improved(P<0.05),the incidence rates of gastrointestinal reaction,neurotoxicity and stomatitis were lower(P<0.05),while there was no significant difference in the incidence rate hematotoxicity(P>0.05).Conclusion For newly diagnosed PCNSL,the addition of rituximab could improve the remission rate and survival rate of PCNSL patients and the incidence rate of adverse reactions is relatively low,which is worthy of clinical promotion.

关 键 词：原发性中枢神经系统淋巴瘤 CD20单克隆抗体 利妥昔单抗 

分 类 号：R739.4[医药卫生—肿瘤]