氟达拉滨与环磷酰胺治疗慢性淋巴细胞白血病的安全性及有效性的.docVIP

氟达拉滨与环磷酰胺治疗慢性淋巴细胞白血病的系统评价 张海红 甘肃省红十字血液中心 兰州 730046 [摘要]目的 系统评价氟达拉滨与环磷酰胺联合用药与氟达拉滨相比治疗慢性淋巴细胞白血病的有效性安全性。方法 按Cochrane系统评价方法，检索Cochrane图书馆（20年第期）计算机检索CNKI（1994～20.3）、CBM（1978～20. 3）、VIP（1989～20.3）、Pubed（1966～20. 3）、EMBASE（19～20. 3），同时手工检索相关杂志和参考文献，选择符合标准的随机对照试验和半随机对照试验按Cochrane协作网提供的方法对纳入文献进行质量评价和结果分析。结果 纳入3个随机对照试验1043例患者。Meta分析显示氟达拉滨与环磷酰胺（FC）联合药与氟达拉滨（F）相比①完全应答率（CR）差异有统计学意义[OR 4.65,95%CI(2.57,8.39)]；②部分应答率（PR）差异无统计学意义[OR 0.91,95%CI(0.64,1.30)]；③完全缓解率（CR）差异有统计学意义[OR 3.77,95%CI(2.50,5.69)]；④无进展生存时间（PFS）差异有统计学意义[OR2.26,95%CI(1.74,2.92)]；⑤生存时间差异无统计学意义结论 FC组在完全应答率、完全缓解率、无进展生存时间方面明显高于F组但部分应答率，生存时间两组化疗方案没有明显差别确切的疗效和安全性还不能肯定需大样本、高质量的随机对照试验加以证实。[关键词] 氟达拉滨；环磷酰胺；慢性淋巴细胞白血病；系统评价 Fludarabine plus cyclophosphamide versus fludarabine for chronic lymphocytic leukemia :A systematic review Zhang Hai-hong The Red Cross Blood Center of GanSu , Lanzhou 730046,China [Abstract] Objective to review the effectiveness and safety of fludarabine plus cyclophosphamide versus fludarabine for chronic lymphocytic leukemia. Methods we searched the specialized trials register of the Cochrane Collaboration’s Bone ,the cochrane library ( Issue 4,2007), CNKI（1994 to January 20）,CBM（1978 to January 20）、VIP（1989 to January 20）、Pubed（1966 to January 20）、EMBASE（19 to January 2010）.We also handedsearched some chinese orthopedic journals .Randomized controlled trials(RCTs) and quai-randomized trials (quai-RCTs).The quality evaluation of studies and data analysis followed the methods of the Cochrane Collaboration.Results Three studies including ,1043 patients met the inclusion criteria,the following data were the results of meta-analysis;①complete response rate ,with a statistically difference OR 4.65,95%CI 2.57 to 8.39;②partial response rate, no statistical difference OR 0.91,95%CI 0.64 to 1.30;③complete remission rate,with a statistically difference OR 3.77,95%CI2.50 to 5.69; ④progression-free survival time, with a statistically difference OR2.26,95%CI1.74 to 2.92;⑤The three studies all reported adverse r