贝伐单抗在晚期结直肠癌维持治疗中疗效和安全性的Meta分析  

The efficacy and safety of maintenance strategies with bevacizumab in metastatic colorectal cancer patients-a Meta-analysis

作　　者：赵磊[1,2] 杨薏帆[1,2] 甄洪超[1,2] 刘文婷[1,2] 肖静[1,2] 曹邦伟[1,2] 

机构地区：[1]首都医科大学附属北京友谊医院肿瘤科 [2]北京市消化疾病中心消化疾病癌前病变北京市重点实验室,北京100050

出　　处：《临床和实验医学杂志》2014年第21期1755-1759,共5页Journal of Clinical and Experimental Medicine

基　　金：国家重点基础研究发展计划(973计划)资助项目;编号:2012CB526600;消化疾病癌前病变北京市重点实验室基金资助项目(编号:2013-2014)

摘　　要：目的系统评价在转移性结直肠癌（m CRC）中加入贝伐单抗进行维持治疗对比持续治疗的疗效和安全性,以期为临床制定化疗策略提供依据。方法计算机检索Pub Med、EMBASE,检索时限截止到2014年10月,查找应用贝伐单抗作为维持治疗的的随机对照临床试验,按照纳入排除标准进行文献筛选、数据提取和质量评价后,采用Stata11.2SE软件进行系统评价。结果共纳入4个研究,合计1 084例患者。Meta分析结果显示：在疗效方面,含有贝伐单抗的维持治疗方案与持续治疗相比,两者的无进展生存期（HR=1.06,95%CI：0.65-1.71）和总生存期（HR=1.08,95%CI：0.93-1.26）相当,但维持治疗组的副作用明显低于持续治疗组（OR=1.51,95%CI：1.22-1.85）,维持治疗组的神经系统疾病（OR=3.70,95%CI：2.33-5.88）和手足综合征（OR=1.90,95%CI：1.05-3.44）发生率明显比持续治疗组低。结论在疗效和安全性上,与含有贝伐单抗的持续治疗方案相比,维持治疗方案可以明显改善患者PFS时间降低副作用。Objective This meta- analysis compared the efficacy and safety of maintenance strategies added bevacizumab with continuous strategies added bevacizumab in metastatic colorectal cancer（ m CRC）. Methods Potentially relevant studies,which has maintenance strategies with bevacizumab from inception to October 2014,were identified through a structured literature search using the Pub Med,EMBASE,and Cochrane databases independently. The statistical analysis was performed according to Stata version 11. 2SE（ Stata Corp）. Results 4 studies were included in the meta- analysis. For PFS or OS of maintenance strategies with bevacizumab versus continuous strategies with bevacizumab（ HR =1. 06,95% CI： 0. 65- 1. 71; HR = 1. 08,95% CI： 0. 93- 1. 26; respectively）. All models suggested similar outcome within the range of non-inferiority. Grade 3 /4 toxicities（ neuropathy- OR = 3. 70,95% CI： 2. 33- 5. 88; hand- foot syndrome- OR = 1. 90,95% CI： 1. 05- 3. 44）were less prominent with maintenance strategies compared to continuous strategies. Conclusion Considerring the efficacy and safety,the maintenance therapies with bevacizumab can significantly improve PFS and reduce grade 3 /4 toxicities.

关 键 词：结直肠癌 贝伐单抗 维持治疗 疗效和安全性 META分析 

分 类 号：R735.3[医药卫生—肿瘤]