Objective:To assess the effectiveness and safety of bortezomib combined with different chemotherapeu-tics for treating multiple myeloma.Methods:Data were searched from PubMed,Cochrane central Register of Con-trolled Trials(CENTRAL)of The Cochrane Library China National Knowledge Infrastructure(CNKI)and China Biol-ogy Medicine(CBM).Data analysis was performed with RevMan 5.3.Results:A total of 8 articles involving 1 627 pa-tients were included.Meta -analysis results showed BTD was better than BD about OR[OR =1.80,95%CI(1.25, 2.61),P =0.002],and the infection rate[OR =1.19,95%CI(0.73,1.94),P =0.48]and 3 and 4 grade thrombo-cytopenia[OR =2.17,95%CI(0.91,5.19),P =0.08]had no significant differences.BAD was better than BD about OR[OR =3.79,95%CI(1.28,11.22),P =0.01].BTD and BMP had no significant differences about OR [OR =1.42,95%CI(0.96,2.09),P =0.08]and 3 and 4 grade adverse events had no significant differences[OR =1.55, 95%CI(0.61,3.90),P =0.35].BCD and BAD had no significant differences about OR[OR =0.99,95%CI(0.61, 1.59),P =0.96],but BCD has better effect than BAD.Conclusion:Bortezomib plus two drugs is better than borte-zomib plus one drugs and the side effect had no significant differences.The different plan about bortezomib plus two drugs have different effect,BCD is the best about BTD,BAD,BCD,BMP.%目的：评价硼替佐米联合不同化疗药物治疗多发性骨髓瘤的疗效与安全性。方法：计算机检索PubMed 数据库，Cochrane 图书馆临床对照试验数据库，中国期刊全文数据库和中国生物医学文献数据库，进一步对纳入文献的参考文献进行扩大搜索。采用 RevMan 5．3软件进行 Meta 分析。结果：共纳入8篇文献，包括1627例患者。Meta 分析显示硼替佐米联合地塞米松和沙利度胺（BTD）组较硼替佐米联合地塞米松（BD）组缓解率好[OR ＝1．70，95％CI（1．18，2．44），P ＝0．005]，感染率[OR ＝1．19，95％CI（0．73，1．94），P ＝0．48]和3－4级血小板减少率[OR ＝2．17，95％CI（0．91，5．19），P ＝0．08]无统计学差异。硼替佐米联合地塞米松和阿霉素（BAD）组较 BD 组缓解率高[OR ＝3．79，95％CI（1．28，11．22），P ＝0．01]。BTD 组和硼替佐米联合马法兰和泼尼松（BMP）组缓解率无统计学差异[OR ＝1．42，95％CI（0．96，2．09），P ＝0．08]。3－4级不良事件发生率无统计学差异[OR ＝1．55，95％CI（0．61，3．90），P ＝0．35]。BAD 组和硼替佐米联合地塞米松和环磷酰胺（BCD）组缓解率无统计学差异[OR ＝0．99，95％CI（0．61，1．59），P ＝0．96]，BCD 组疗效好于 BAD组。结论：硼替佐米三药联合较硼替佐米二药联合效果好，毒副反应基本相同。不同的三药联合方案效果也不同，在 BTD、BAD、BCD、BMP 这几个方案中，BCD 效果最好。
展开▼
