多西紫杉醇单周与三周方案对转移性乳腺癌的有效性及安全性的meta分析  

The Efficacy and Toxicity of Weekly Versus Three-weekly Docetaxel Regimens for Metastatic Breast Cancer: A Meta-analysis

作　　者：刘思旸 李爱民[1] 张军一[1] 李荣[1] 罗荣城[1] 

机构地区：[1]南方医科大学南方医院肿瘤中心,510515

出　　处：《实用癌症杂志》2014年第6期640-644,650,共6页The Practical Journal of Cancer

基　　金：国家自然科学基金资助项目(批准号:81272546)

摘　　要：目的比较分析多西紫杉醇单周与三周方案对转移性乳腺癌的有效性与安全性.方法对Pubmed、Co-chranelibrary、EMbased、CNKI、ASCO会议摘要以及WHO官网进行相关文献搜索,检索截止时间为2013年3月11日.纳入有关多西紫杉醇单周与三周方案安全性与有效性的随机对照试验.结果共6个研究包括5篇全文和一篇会议摘要纳入meta分析.多西紫杉醇单周方案与三周方案相比,无论在ORR、PFS、OS等方面均无统计学差异.在安全性分析中,单周方案3～4级中性粒细胞减少性发热的发生率显著低于三周方案（纳入3篇文献,共356例患者,OR0.16,95%CI0.06～0.43,P〈0.001）.同样中性粒细胞减少以及神经毒性的发生率单周方案也显著降低.结论多西紫杉醇单周化疗方案对转移性乳腺癌患者的有效性与三周方案相同,但鉴于单周方案的不良反应发生率低、耐受性好,老年患者或-般情况较差的患者更适合单周方案化疗.Objective To study the efficacy and toxicity of weekly versus 3-weekly docetaxel regimens for metastatic breast cancer. Methods Pubmed,Cochrane library,EMbased database,ASCO annual meeting abstracts,WHO website( ongoing studies) and CNKI database were searched for relevant publications up to March 11,2013. Randomized controlled studies comparing weekly with 3-weekly docetaxel in MBC patients were studied. Results 6 eligible trials including 5 full-text articles and 1conference abstracts were included in this systematic review. No significant differences were observed between weekly versus 3-weekly docetaxel in objective response rate( ORR),progression free survival( PFS) or overall survival( OS). With regard to the toxicity profile,the incidence of grade 3 ~ 4 neucopenic fever was notably lower among patients receiving weekly docetaxel( 3studies,356 patients,pooled OR 0. 16,95% CI 0. 06-0. 43,P < 0. 001). The incidence of grade 3 ~ 4 neucopenia and neurotoxicity was also significantly lower in the weekly docetaxel regimen. Conclusion Weekly docetaxel provides equal effects as the standard 3-weekly regimen for MBC patients. Considering its preferred toxicity profiles,weekly docetaxel regimen might be a better choice for elderly patients or those with poor performance status.

关 键 词：多西紫杉醇 转移性乳腺癌 META分析 

分 类 号：R737.9[医药卫生—肿瘤]