Wei SiYao, Chang LanYin, Zhong Yi
Department of Neurology, The Affiliated Hospital of Southwest Medical University, Luzhou, China.
Department of Otolaryngology Head and Neck Surgery, The Affiliated Hospital of Southwest Medical University, Luzhou, China.
Front Med (Lausanne). 2024 Jul 2;11:1419038. doi: 10.3389/fmed.2024.1419038. eCollection 2024.
To assess the efficacy and adverse events of bevacizumab (BEV) combined with temozolomide (TMZ) in the treatment of glioma.
Randomized controlled trials (RCT) involving BEV combined with TMZ in the treatment of glioma were searched using PubMed, Embase and Cochrane library, and a comprehensive meta-analysis was conducted. The primary outcomes were overall survival time (OS) and progression-free survival time (PFS), and the secondary outcome was adverse events. Researchers conducted literature screening, data extraction and quality assessment according to inclusion and exclusion criteria. RevMan 5.3 software was used for meta-analysis.
A total of 8 prospective RCTs of 3,039 cases were included in the meta-analysis. Meta-analysis showed that compared with TMZ alone, BEV combined with TMZ could significantly improve PFS, OS and complete remission rate (CR). A total of 6 studies reported related adverse events, mainly including thrombocytopenia, neutropenia, leukopenia, anemia and fatigue. Combination therapy may have more adverse events but no serious consequences.
The combination of BEV and TMZ had a better therapeutic effect on glioblastoma, significantly prolonged the survival time of patients and improved the quality of life. However, some patients are afflicted with the adverse events of combination therapy, and subsequent studies should continue to conduct larger, multi-center RCTs to confirm the findings and explore in depth how to minimize and manage adverse events effectively.
评估贝伐单抗（BEV）联合替莫唑胺（TMZ）治疗胶质瘤的疗效及不良事件。
通过检索PubMed、Embase和Cochrane图书馆，纳入有关BEV联合TMZ治疗胶质瘤的随机对照试验（RCT），并进行全面的荟萃分析。主要结局指标为总生存时间（OS）和无进展生存时间（PFS），次要结局指标为不良事件。研究人员根据纳入和排除标准进行文献筛选、数据提取及质量评估。采用RevMan 5.3软件进行荟萃分析。
荟萃分析共纳入8项前瞻性RCT，涉及3039例患者。荟萃分析表明，与单纯TMZ相比，BEV联合TMZ可显著改善PFS、OS及完全缓解率（CR）。共有6项研究报告了相关不良事件，主要包括血小板减少、中性粒细胞减少、白细胞减少、贫血和疲劳。联合治疗可能会有更多不良事件，但无严重后果。
BEV与TMZ联合应用对胶质母细胞瘤有较好的治疗效果，可显著延长患者生存时间，提高生活质量。然而，部分患者会出现联合治疗的不良事件，后续研究应继续开展更大规模、多中心的RCT以证实研究结果，并深入探索如何有效减少和处理不良事件。
