肿瘤电场治疗联合替莫唑胺治疗胶质母细胞瘤的快速卫生技术评估  

Tumor Treating Fields Plus Maintenance Temozolomide for the Treatment of Patients with Glioblastoma:a Rapid Health Technology Assessment

作　　者：周善炎 陈英耀[1] 徐子安 项予良 刘世蒙 Zhou Shanyan;Chen Yingyao;Xu Zi'an;Liu Shimeng(School of Public Health,Fudan University/Key Laboratory of Health Technology Assessment,National Health Commission(Fudan University),Shanghai,200032,China;不详)

机构地区：[1]复旦大学公共卫生学院·国家卫生健康委员会卫生技术评估重点实验室(复旦大学),上海200032

出　　处：《中国医院管理》2024年第10期49-54,共6页Chinese Hospital Management

基　　金：国家自然科学基金面上项目(72074047)。

摘　　要：目的 快速评估肿瘤电场治疗(tumor treating fields,TTFields)联合化疗药物替莫唑胺(temozolomide,TMZ)治疗胶质母细胞瘤(glioblastoma,GBM)患者的安全性、有效性和经济性,为医疗卫生相关决策提供可得的最佳证据。方法 检索PubMed、Embase、 Cochrane Library、中国知网、万方数据库,检索时间为建库至2023年7月,搜集TTields联合TMZ治疗GBM患者的高质量临床研究、系统评价/Meta分析、卫生经济学评价文献,评价纳入研究的偏倚风险后进行描述性分析。结果 共纳入19篇文献,其中随机对照试验5篇、回顾性研究3篇、系统评价/Meta分析8篇、卫生经济学评价3篇。证据质量参差不齐,多数证据支持TTFields联合TMZ对GBM患者治疗有利,但多数卫生经济学评价研究认为该疗法不具有经济性。结论 当前证据显示,相较于TMZ标准治疗,TTFields联合TMZ治疗GBM具有更好的安全性和有效性,但关于其经济性的证据尚未形成统一结论。Objective It conducted a rapid health technology assessment to evaluate the comparative safety,efficacy and economy of tumor treating fields(TTFields) combined with temozolomide treatment versus temozolomide(TMZ) alone for patients with glioblastoma(GBM). Methods It provided an extensive electronic search of databases,including PubMed,Embase,Cochrane Library,CNKI,and WanFang Data,to collect clinical evidence and health economic evaluations related to the, safety, efficacy, and economy of TTFields for Glioblastoma patients. The search covered literature from inception to July,2023,and assessed the risk of bias in the included studies. Descriptive analyses and data summaries were performed. Results A total of 19 references were included, comprising 5 randomized controlled trials, 3 retrospective studies, 8 systematic reviews or meta-analyses, and 3 cost-effectiveness analysis(CEA) studies. The quality of the literature evidence was heterogeneous. Recent meta-analyses mostly support the conclusion that TTFields combined with TMZ treatment provides a survival benefit compared to standard TMZ alone. However, the cost-effectiveness analysis literature from 2 countries showed different results,likely due to differences in socioeconomic levels,health systems,and heterogeneity in sources,model selection,and parameter selection. The majority of evidence supports the benefits of TTFields combined with TMZ for the treatment of GBM patients,but the results of CEAs tend to favor the view that this therapy is not cost-effective. Conclusion Current evidence indicates that TTFields combined with TMZ treatment have better safety and efficacy. However,there is still no consensus on whether it is cost-effective.

关 键 词：肿瘤电场治疗 替莫唑胺 胶质母细胞瘤 快速卫生技术评估 

分 类 号：R197.323.2[医药卫生—卫生事业管理]