卡培他滨联合多烯紫杉醇治疗转移性乳腺癌的系统评价  

Capecitabine plus Docetaxel for Metastatic Breast Cancer:A Systematic Review

作　　者：李亚丽[1,2] 肖佳灵[1,3] 杨克虎[1] 马彬[1] 

机构地区：[1]兰州大学循证医学中心,兰州大学基础医学院,兰州730000 [2]兰州大学第二临床医学院,兰州730000 [3]兰州大学口腔医学院,兰州730000

出　　处：《中国循证医学杂志》2009年第8期893-898,共6页Chinese Journal of Evidence-based Medicine

基　　金：兰州大学循证医学中心"循证医学本科生教学创新基金"(2008LDEBM-B)

摘　　要：目的系统评价卡培他滨联合多烯紫杉醇与多烯紫杉醇单用对于蒽环类药物治疗失败的转移性乳腺癌患者的疗效和安全性。方法计算机检索PubMed、EMbase、Cochrane图书馆(2008年第4期)及中国生物医学文献数据库等数据库,纳入卡培他滨联合多烯紫杉醇与多烯紫杉醇单用对比治疗蒽环类药物治疗失败的转移性乳腺癌的随机或半随机对照试验,检索日期截止至2008年9月。按Cochrane系统评价方法评价纳入研究的方法学质量,提取有效数据后使用RevMan5.0软件对总生存期、疾病进展时间、反应率、中位生存期、不良反应与生存质量进行Meta分析。结果共纳入3个随机对照试验,包括672例患者,Meta分析结果显示卡培他滨联合多烯紫杉醇在总生存期[MD=3.00,95%CI(1.64,4.36)]、疾病进展时间[MD=1.85,95%CI(1.15,2.55)]和反应率[RR=1.29,95%CI(1.09,1.52)]方面优于多烯紫杉醇单用。结论目前证据表明卡培他滨联合多烯紫杉醇短期疗效明显优于多烯紫杉醇单用,但在不良反应和远期效果方面尚不清楚,需要更多高质量随机对照试验进一步证实。Objective To systematically evaluate the clinical effectiveness and safety of capecitabine plus docetaxel in the treatment of patients with metastatic breast cancer where anthracycline has failed as a treatment. Methods We electronically searched PubMed, EMBASE, the Cochrane Library （2008, issue 4）, and CBM to Sept. 2008. Randomized controlled trials （RCTs） and quasi-RCTs about capecitabine plus docetaxel combination therapy in anthracycline-pretreated patients with metastatic breast cancer were identified. Study selection and analyses were undertaken according to the Cochrane Handbook, and RevMan 5.0 was applied for statistical analyses. The following was studied： total survival time, the development time of disease, reaction rate, the mid-survival time, adverse events and quality of life. Results Three RCTs involving 672 patients with metastatic breast cancer were included. The results of meta-analyses showed that the overall survival （MD=3.00, 95%CI 1.64 to 4.36）, disease time to progression （MD=1.85, 95%CI 1.15 to 2.55）, and the response rate （RR=1.29, 95%CI 1.09 to 1.52） were superior in the combination arm to the docetaxel alone arm. Contusion The current evidence available shows that the combination of capecitabine and docetaxel may significantly improve the short-term efficacy comparing with docetaxel alone. However, adverse events and long-term efficacy are not clear; more high-quality RCTs should be conducted.

关 键 词：转移性乳腺癌 卡培他滨 多烯紫杉醇 系统评价 

分 类 号：R737.9[医药卫生—肿瘤]