本文選題：間變性膠質(zhì)細(xì)胞瘤 + WHOⅢ級(jí)��； 參考：《中南大學(xué)》2014年碩士論文

【摘要】：目的：評(píng)價(jià)間變性膠質(zhì)細(xì)胞瘤術(shù)后聯(lián)合放化療對(duì)比單獨(dú)放療總生存時(shí)間和無(wú)進(jìn)展生存期是否提高。 方法：計(jì)算機(jī)檢索Medline (PubMed)、Embase和Cochrane L ibrary以及CNKI中文數(shù)據(jù)庫(kù)中2001年1月至2013年1月研究間變性膠質(zhì)瘤術(shù)后放化療聯(lián)合治療對(duì)比單獨(dú)放療的文獻(xiàn),評(píng)價(jià)納入文獻(xiàn)的質(zhì)量并進(jìn)行資料提取后,采用stata12.0軟件進(jìn)行Meta分析。本次納入的文獻(xiàn)符合以下標(biāo)準(zhǔn)：1.必須是聯(lián)合放化療對(duì)比單獨(dú)放療的隨機(jī)對(duì)照臨床試驗(yàn)。2.試驗(yàn)對(duì)比的是病人的總生存時(shí)間和／或無(wú)進(jìn)展生存期。3.病理診斷為間變性膠質(zhì)瘤。 結(jié)果：共納入4個(gè)RCT,總共963個(gè)病人。Meta分析結(jié)果顯示：與單純術(shù)后放療相比,術(shù)后聯(lián)合放化療總生存時(shí)間有顯著性提高(HR=0.84,95%CI0.72-0.98, P=0.031),無(wú)進(jìn)展生存期也有顯著性提高(HR=0.68,95%CI0.57--0.80, p=0.000)。亞組分析顯示：AA組術(shù)后放化療聯(lián)合治療與術(shù)后單獨(dú)放療相比,總生存時(shí)間沒(méi)有顯著性差異(HR=0.79,95%CI0.61-1.02, p=0.072), AO/AOA組的結(jié)果與AA組相似(](HR=0.87,95%CI0.71-1.07, p=0.183)。伴有l(wèi)p/19q染色體雜合子缺失的患者與不伴有l(wèi)p/19q缺失的患者相比,總生存時(shí)間有顯著性提高(](HR=0.299,95%CI0.207-0.433, P=0.000)。 結(jié)論：通過(guò)本次meta分析表明,間變性膠質(zhì)瘤的輔助化療在治療方案中扮演了有益的角色,聯(lián)合放化療可以提高患者的總生存時(shí)間和無(wú)進(jìn)展生存期,但伴隨較大的毒副反應(yīng)；伴有l(wèi)p/19q染色體雜合子缺失的患者對(duì)化療更敏感,是間變性膠質(zhì)瘤有利的預(yù)后因素。
[Abstract]:Objective: to evaluate the improvement of total survival time and progression free survival in patients with anaplastic glioma after surgery combined with radiotherapy and chemotherapy alone. Methods: the literatures of Medline pubMedus Embase and Cochrane L ibrary and CNKI Chinese database from January 2001 to January 2013 were searched and compared with radiotherapy alone. The quality of the literature was evaluated and the data were extracted. Meta analysis was carried out with stata12.0 software. The literature included this time meets the following criteria: 1. 1. Must be combined with radiotherapy versus radiotherapy alone in randomized controlled clinical trial. 2. The trial compared the patient's total survival time and / or progression-free survival of 3. 3. The pathological diagnosis was anaplastic glioma. Results: a total of 963 patients. Meta-analysis showed that compared with postoperative radiotherapy alone, the total survival time of postoperative combined radiotherapy and chemotherapy was significantly improved by HR0.84% 95% CI 0.72-0.98, P < 0.031%, and the progression-free survival time was also significantly increased by 0.6895CI 0.57- 0.80, p0.000 ~ 0.000. The results of subgroup analysis showed that there was no significant difference in total survival time between the two groups compared with radiotherapy alone. The results of AO/AOA group were similar to those of AA group (P 0.183). Compared with those without lp/19q deletion, the total survival time of patients with lp/19q heterozygote deletion was significantly increased (P < 0.29995 CI 0.207-0.433, P = 0.000). Conclusion: the meta analysis shows that adjuvant chemotherapy plays a beneficial role in the treatment of anaplastic glioma. Combined radiotherapy and chemotherapy can improve the total survival time and progression free survival of the patients, but with a large toxicity. Patients with lp/19q heterozygote deletion are more sensitive to chemotherapy and are favorable prognostic factors for anaplastic glioma.
【學(xué)位授予單位】：中南大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R739.4

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