对复发的监测测试是否可以改善儿童急性白血病化疗后的生存率? 一个系统的审查
Connor Evans1, Hollie Melton1, Yiwen Liu1
1Centre for Reviews and Dissemination, University of York, York, UK.
Pediatric blood & cancer
|September 7, 2025
概括
在儿童和青少年急性白血病治疗后的例行监测 (CYP) 并没有改善生存结果. 目前的证据表明,复发检测的益处有限,强调需要更好地设计研究.
科学领域:
- 儿科瘤学 儿科瘤学
- 癌症的生存率 癌症的生存率
- 临床研究方法论 临床研究方法论
背景情况:
- 急性白血病是儿童和青少年 (CYP) 中最常见的癌症.
- 治疗后的监测是为了检测复发而实施的,但其对生存和生活质量的影响仍然不确定.
- 目前关于儿童急性白血病监测有效性的证据有限.
研究的目的:
- 系统地审查治疗后监测CYP中急性白血病的证据.
- 评估监测对生存结果,复发检测和成本效益的影响.
- 确定当前关于儿童急性白血病监测的研究中的差距.
主要方法:
- 对13个数据库和2个试验注册表进行了系统审查,其中包括1990年以后发表的研究.
- 研究的重点是治疗后接受监测的急性白血病的CYP (≤17年).
- 关于生存,监测性能,成本效益和患者经验的数据被提取并用叙述方式合成.
主要成果:
- 包括64项研究,其中30项评估监督. 分析了5672个CYP,而747人经历了复发.
- 症状检测的复发是最常见的,但监测并没有显著影响整体或无事件存活率.
- 报告质量很差,阻碍了评估. 监测计划是昂贵的,没有研究解决了患者报告的结果或负担.
结论:
- 目前的证据对监测在检测急性白血病中CYP复发中的作用提供了最小的支持.
- 高质量的前性,纵向性和随机化研究是必要的,以澄清监控的好处和负担.
- 未来的研究应该专注于关键成果,并确保强有力的报告标准.
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