香菇多糖治疗恶性胸腔积液随机对照试验的Meta分析  

Lentinan for treatment of malignant pleural effusion:A meta-analysis of randomized controlled trials

作　　者：冯丹[1] 刘佳丽[1] 许崇安[1] 

机构地区：[1]中国医科大学附属第四医院肿瘤内科,辽宁沈阳110032

出　　处：《中华肿瘤防治杂志》2011年第20期1620-1623,共4页Chinese Journal of Cancer Prevention and Treatment

摘　　要：目的:运用系统评价Meta分析的方法评价香菇多糖(LNT)单药或联合其他药物治疗恶性胸腔积液(MPE)的临床疗效及安全性。方法:应用Pubmed、Cochrane图书馆、Embase、CBM、CNKI、维普及万方数据库系统,全面收集有关LNT单药或联合其他药物治疗MPE的临床对照研究。结果:本系统评价共纳入17篇随机对照试验,共计978例患者,其中LNT组500例,顺铂组478例。Meta分析结果显示,LNT组临床有效率明显优于顺铂组(OR=3.68,95%CI=2.75～4.94;P<0.000 01);LNT组治疗后Karnofsky评分升高患者例数均显著多于顺铂组患者(OR=3.79,95%CI=2.46～5.84,P<0.000 01),其降低及稳定患者例数明显低于顺铂组患者(OR=0.41,95%CI=0.21～0.78,P=0.007;OR=0.37,95%CI=0.22～0.60,P<0.000 1);LNT组胃肠道反应和血液学毒性发生率较顺铂组明显减少(OR=0.31,95%CI=0.21～0.47,P<0.000 01;OR=0.49,95%CI=0.28～0.84,P=0.01)。结论:现有证据表明,LNT单药或联合其他药物治疗MEP的临床疗效及安全性均优于顺铂单药,可广泛应用于临床治疗晚期肿瘤恶性胸腔积液。OBJECTIVE： To investigate the efficacy and safety of lentinan （LNT） for the treatment of malignant pleural effusion （MPE） by conducting a meta-analysis. METHODS： Publications addressing the efficacy and safety of LNT for the treatment of MPE were selected from Pubmed, Cochrane library, Embase, CBM, CNKI, VIP and Wanfang databases. RESULTS： Seventeen studies involving 978 patients were identified, with 500 patients in LNT group and 478 patients in cisplatin group. Patients in LNT group has a better clinical response rate than those in cisplatin group （OR = 3.68, 95%CI 2.75-4.94; P〈0.000 01）; There was sig nificant difference between LNT group and cisplatin group on rising ratio of Karnofsky scores （OR = 3. 79, 95% CI 2.46 5.84, P〈0. 000 01）. Meanwhile, decreasing and stable ratio also had an obviously significant difference between LNT group and eisplatin group （OR=0.41, 95%CI=0.21 0.78, P=0.007; OR=0.37; 95%CI=0.22 0.60, P〈 0. 000 1）. In addition, LNT group had lower incidence of gastrointestinal reactions and hematological toxicity （OR 0.31, 95%CI=0. 21 0. 47, P〈0. 000 01; OR=0. 49, 95%CI=0. 28-0. 84, P=0.01）. CONCLUSION： Evidences show that lentinan single and combination regimen has a better clinical efficacy and safety.

关 键 词：胸腔积液 恶性 香菇多糖 随机对照试验 META分析 

分 类 号：R730.5[医药卫生—肿瘤]