兰州大学机构库 >学院待认领
替莫唑胺对比传统化疗药治疗高级别脑 胶质瘤的循证研究
Alternative TitleThe Evidence-based Study of TMZ vs Traditional Chemotherapy Drugs to Treatment High Grade Glioma
田宏亮
Thesis Advisor杨克虎
2014-05-24
Degree Grantor兰州大学
Place of Conferral兰州
Degree Name硕士
Keyword胶质瘤 替莫唑胺 替尼泊苷 顺铂 Meta分析 历史性队列研究
Abstract目的 本研究在对替莫唑胺(Temozolomide, TMZ)与传统化疗药治疗高级别脑胶质瘤的有效性和安全性进行系统评价的基础上,利用历史性队列研究方法收集TMZ方案和传统化疗药替尼泊苷联合顺铂方案治疗高级别脑胶质瘤的临床资料,分析比较两组药物临床疗效,从而为临床决策提供证据参考。 方法 ①计算机检索相关数据库纳入TMZ对比传统化疗药治疗脑胶质瘤的随机对照试验,检索时间截至2013年12月。采用质量评价工具评价纳入研究质量;②采用历史性队列研究方法,客观评价TMZ方案和VP方案治疗脑胶质瘤的临床疗效及经济学指标 结果 ①Meta分析结果显示,在治疗有效率、5年生存率、无进展生存期、平均生存期、消化道反应和骨髓抑制等方面两组差异均有统计学意义,TMZ组优于传统化疗药组;②历史性队列研究共纳入患者31例,TMZ组16例,VP组15例,研究结果提示:TMZ组与VP组的近期疗效无明显统计学差异,而TMZ组在单次平均总住院费用及单次化疗平均住院费用上高于VP组,Cox回归分析提示年龄与病理分级是脑胶质瘤患者预后的独立影响因素。 结论 ①系统评价研究显示,两组化疗方案在治疗高级别脑胶质瘤的比较上,TMZ组化疗效果优于传统化疗药组;②TMZ组与VP组对于高级别脑胶质瘤的治疗效果相当,但TMZ组经济学负担更重。
Other AbstractObjective Based on the systematic review, using the historical cohort way research the two groups and do statistic analysis on the data. This study would provide the evidence of EBM in clinical practice for TMZ vs VM-26+DDP to treat high grade glioma. Methods The literatures of randomized controlled trials comparing temozolomide with traditional chemotherapy drugs for glioma patients were retrieved by searching Databases from their inception date to Dec 2013. Two researchers independently screened literatures according to the predefined inclusion and exclusion criteria, extracted data, and assessed the methodological quality of included studies. Meta-analysis was performed by using RevMan 5.2 software. Using the historical cohort way objectively evaluate the curative and untoward effect and economics of TMZ vs VM-26+DDP on glioma. Results A total of 8 RCTs involving 864 patients were finally selected, with 374 cases in TMZ group and 490 cases in traditional chemotherapy drugs group. The baseline data of each trial were preferably comparable. The results of meta-analyses showed that the therapy effective rate, five-year survival rate, the progression-free survival, the average survival were significantly increased in TMZ group compared with traditional chemotherapy drugs group for the treatment of glioma patients of postoperative radiotherapy (all P<0.05). And alimentary tract reactions, marrow depression were significantly reduced in TMZ group compared with traditional chemotherapy drugs group for the treatment of glioma patients. The historical cohort proved the curative effect and safety have no difference between two groups. Moreover, economic evaluation showed TMZ group costed higher than VP group. Conclusions Compared with traditional chemotherapy drugs, TMZ is safe and reliable with better overall curative effect, less adverse reactions and prolonged survival time for glioma patients of postoperative radiotherapy. Current available evidence demonstrated the curative effect in TMZ and VP is similar, however, TMZ costs higher than VP.
URL查看原文
Language中文
Document Type学位论文
Identifierhttps://ir.lzu.edu.cn/handle/262010/222635
Collection学院待认领
Affiliation临床医学院
Recommended Citation
GB/T 7714
田宏亮. 替莫唑胺对比传统化疗药治疗高级别脑 胶质瘤的循证研究[D]. 兰州. 兰州大学,2014.
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