紫杉醇剂量密度方案化疗在上皮性卵巢癌应用的疗效及安全性meta分析  

A meta-analysis of paclitaxel-based chemotherapies administered once every week compared with once every 3 weeks treatment of advanced epithelial ovarian cancer

作　　者：梁江红[1] 冷小飞[1] 程萍[1] 黄晓蓉[1] 刘永珍[1] 

机构地区：[1]湖北省十堰市太和医院妇科,十堰442000

出　　处：《现代妇产科进展》2015年第6期416-420,共5页Progress in Obstetrics and Gynecology

基　　金：十堰市太和医院2014年苗圃计划项目(No:EBM2014033);2013年十堰市科技局指导项目

摘　　要：目的：：评价紫杉醇剂量密度化疗方案治疗上皮性卵巢癌（ EOC）的疗效及安全性。方法：采用计算机检索Cochrane图书馆、PubMed、Embase、ASCO、中国生物医学文献数据库、中国期刊全文数据库、万方数据库中从建库至2014年12月31日关于紫杉醇周疗治疗上皮性卵巢癌与传统月疗方案比较的临床随机对照试验。由两名评价者独立按Cochrane系统评价手册5.1版推荐的RCT标准评价纳入研究的质量,并采用Cochrane协作网提供的RevMan 5.3软件进行Meta分析,无进展生存期（ PFS）及总生存期（ OS）合并统计量为风险比（ HR）,不良反应合并统计量为相对危险度（ RR）。结果：纳入5项随机对照试验共2589例患者。 Meta分析结果显示,与传统化疗方案相比,紫杉醇周疗在PFS （HR=0.91,95%CI 0.83~1.01）及OS（HR=1.01,95%CI 0.81~1.25）上并未显示明显优势。安全性分析显示,紫杉醇周疗方案发生贫血的风险较传统方案高（ RR=1.32,95%CI 1.00~1.75）,但对关节痛/肌痛具有保护作用（ RR=0.70,95%CI 0.59~0.83）。结论：目前证据表明,紫杉醇周疗相较于传统3周疗法并未在改善患者OS及PFS上显示明显优势,但由于纳入文献较少,故需对此结论持审慎态度。尚需进一步开展大规模、高质量的临床研究进行证实。由于两种方案的不良反应谱不同,仍可以为临床提供参考意义。Objective：To evaluate the efficacy and safety of dose dense delivery of pa-clitacel in advanced epithelial ovarian cancer. Methods：We searched the Cochrane Library, PubMed,Embase,ASCO,CBM,CNKI and Wanfang datebases for studies published from begin-ning to 2014 that evaluated the efficacy and safety of dose dense delivery of paclitacel in ad-vanced epithelial ovarian cancer. Two reviewiers independently retrieved clinical controlled trails according to the inclusion and exclusion criteria,assessed the methodological quality of in-cluded trials,and extracted date. Meta analysis was performed by RevMan 5. 3 software. Re-sults：Five studies （2589 patients） were ultimately included. The meta-analysis demonstrated that there was no progressive free disease（PFS,HR=0. 91,95%CI 0. 83 ~1. 01）and overall survival（OS,HR=1. 01,95%CI 0. 81~1. 25）benefit with dose dense therapy. Dose dense reg-imens caused a small increase in anemia（RR=1. 32,95%CI 1. 00~1. 75）,but decreased the incidence of Arthralgia/Myalgia. Conclusion：Thus far Dose dense therapy havenˊt shown any o-verall survival or progression free survival benefits for the treatment of advanced epithelial ovari-an cancer. But the differences in trial design, especially the variety of paclitaxel dosing, limit meaningful cross-trial comparisons. The ongoing clinic trials will clarify the effect of dose dense＆amp;nbsp;therapy.

关 键 词：紫杉醇剂量密度化疗 随机对照试验 上皮性卵巢癌 META分析 

分 类 号：R737.33[医药卫生—肿瘤]