Department of Hematology & Oncology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.
Leuk Res. 2012 Aug;36(8):1016-21. doi: 10.1016/j.leukres.2012.04.001. Epub 2012 May 10.
We performed a meta-analysis of randomized controlled trials comparing thalidomide maintenance with other regimens after induction chemotherapy for multiple myeloma. Overall, 6 trials including 2786 patients were identified. Patients treated with thalidomide maintenance had marginally better overall survival (hazard ratio HR 0.83, P=0.07). The improvement was especially prominent in a subgroup of studies using corticosteroids with thalidomide (HR 0.70, P=0.02). Thalidomide improved progression-free survival (HR 0.65, P<0.01), but had more frequent venous thrombosis (risk difference 0.024, P<0.05) and peripheral neuropathy (risk difference 0.072, P<0.01). These results suggest that thalidomide maintenance with corticosteroids is effective in prolonging survival for multiple myeloma.
我们对比较来那度胺维持治疗与多发性骨髓瘤诱导化疗后其他方案的随机对照试验进行了荟萃分析。共有 6 项试验，包括 2786 例患者被纳入分析。来那度胺维持治疗组患者的总生存情况略有改善（风险比 HR 0.83，P=0.07）。在使用来那度胺联合皮质类固醇的亚组研究中，改善尤为显著（HR 0.70，P=0.02）。来那度胺改善了无进展生存期（HR 0.65，P<0.01），但静脉血栓形成的风险更高（风险差异 0.024，P<0.05）和周围神经病变的风险更高（风险差异 0.072，P<0.01）。这些结果表明，来那度胺联合皮质类固醇维持治疗可有效延长多发性骨髓瘤患者的生存。
