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利妥昔单抗为基础的免疫化疗治疗弥漫性大B细胞淋巴瘤时中期(18)F-FDG-PET的预后价值:一项系统评价和荟萃分析

Prognostic value of interim (18)F-FDG-PET in diffuse large B cell lymphoma treated with rituximab-based immune-chemotherapy: a systematic review and meta-analysis.

作者信息

Zhu Danxia, Xu Xiao-Li, Fang Cheng, Ji Mei, Wu Jun, Wu Chang-Ping, Jiang Jing-Ting

机构信息

Department of Oncology, The Third Affiliated Hospital of Soochow University Changzhou 213003, China.

Department of Geriatric Medicine, The Third Affiliated Hospital of Soochow University Changzhou 213003, China.

出版信息

Int J Clin Exp Med. 2015 Sep 15;8(9):15340-50. eCollection 2015.

Abstract

The prognostic value of an interim fluorine-18-fluorodeoxyglucose positron emission tomography ((18)F-FDG PET) for diffuse large B-cell lymphoma (DLBCL) has been assessed by different groups. However, studies have suggested that the use of rituximab could limit the predictive value of interim (18)F-FDG PET for DLBCL. To clarify the prognostic value of interim (18)F-FDG PET in DLBCL patients treated with rituximab based immunochemotherapy, we searched for relevant studies in PubMed, the Cochrane Library and EMBASE. A random versus fixed effects model was applied according to the heterogeneity. According to the literature search strategies, 11 studies were identified. The pooled HR comparing PFS between patients with positive and negative results was 2.96 (95% CI=2.25-3.89). The patients in interim (18)F-FDG PET negative group had a higher CR rates than that in interim (18)F-FDG PET positive group (RR=5.53, 95% CI=2.59-11.80). Consistent evidence favoring interim (18)F-FDG PET-based treatment assessment should be considered in the management of patients with DLBCL.

摘要

不同研究团队已对中期氟-18-氟脱氧葡萄糖正电子发射断层扫描((18)F-FDG PET)在弥漫性大B细胞淋巴瘤(DLBCL)中的预后价值进行了评估。然而,研究表明,利妥昔单抗的使用可能会限制中期(18)F-FDG PET对DLBCL的预测价值。为了阐明在接受基于利妥昔单抗的免疫化疗的DLBCL患者中,中期(18)F-FDG PET的预后价值,我们在PubMed、Cochrane图书馆和EMBASE中检索了相关研究。根据异质性应用随机或固定效应模型。根据文献检索策略,共纳入11项研究。结果为阳性和阴性的患者之间比较无进展生存期的合并风险比为2.96(95%可信区间=2.25-3.89)。中期(18)F-FDG PET阴性组患者的完全缓解率高于中期(18)F-FDG PET阳性组(风险比=5.53,95%可信区间=2.59-11.80)。在DLBCL患者的管理中,应考虑支持基于中期(18)F-FDG PET进行治疗评估的一致证据。

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