^(89)SrCl_2联合^(99)Tc-MDP治疗骨转移瘤疗效的Meta分析  

^(89)SrCl_2 combined with ^(99)Tc-MDP in patients with bone metastases:a Meta-analysis

作　　者：王洪良[1] 肖国有[1] 李党生[1] 姚忠强[1] 韦琳琳 邓李燕[1] 李宁[1] 黎乐群[2] 

机构地区：[1]广西医科大学附属肿瘤医院核医学科,南宁530021 [2]广西医科大学附属肿瘤医院肝胆外科,南宁530021

出　　处：《中国癌症防治杂志》2015年第6期416-420,共5页CHINESE JOURNAL OF ONCOLOGY PREVENTION AND TREATMENT

基　　金：国家自然科学基金资助项目(81160262)

摘　　要：目的评价氯化锶(^(89)Cl_2)联合锝-99-亚甲基二膦酸盐(^(99)Tc-MDP,云克)治疗骨转移瘤的疗效。方法计算机检索Cochrane图书馆临床对照试验资料库、PubMed、EMBASE、万方数据库、中国生物医学文献数据库、中文科技期刊全文数据库和中国期刊全文数据库,收集公开发表的关于^(89)SrCl_2联合^(99)Tc-MDP治疗与^(89)SrCl_2单药治疗骨转移瘤的随机对照试验(RCT),无语种限制,检索截止日期至2015年6月。对纳入的文献进行资料提取和质量评价,采用Revman5.3软件进行Meta分析。结果 7篇文献符合纳入标准,共691例患者。Meta分析结果显示,与^(89)SrCl_2单药组比较,^(89)SrCl_2联合^(99)Tc-MDP治疗可提高骨转移瘤患者的骨痛缓解有效率(RR=0.16,95%CI:0.10~0.22,P<0.001),骨显像有效率(RR=1.31,95%CI:1.07~1.60,P=0.009)及KPS评分提高率(RR=1.68,95%CI:1.33~2.12,P<0.001)。^(89)SrCl_2单独或联合^(99)Tc-MDP治疗的常见不良反应为骨髓抑制,主要为白细胞、血小板降低。结论对于恶性肿瘤骨转移患者,^(89)SrCl_2联合^(99)Tc-MDP治疗较^(89)SrCl_2单独治疗明显提高骨痛缓解有效率、骨显像有效率及KPS评分提高率。Objective To evaluate the efficacy of 89SrCl2 combined with 99Tc-MDP for patients with bone metastases. Methods Randomized controlled trials published up to June 2015 that compared 89SrCl2 combined with 99Tc-MDP and 89SrCl2 alone for treating patients with bone metastases were retrieved from databases including the Cochrane Library, PubMed, EMBASE,WanFang, CBM,CNKI,and VIP. The quality of eligible studies was evaluated,and data were meta-analyzed using Revman 5.3. Results A total of 7 RCTs involving 691 patients were included in the meta-analysis. The combination of 89SrCl2 and 99Tc-MDP led to significantly higher efficacy in bone pain palliation （RR =0.16,95% CI：0.10-0.22）,higher radionuclidc bone scan score （ RR = 1.31,95 % CI： 1.07-1.60 ） and higher KPS score （ RR = 1.68, 95 % CI： 1.33-2.12 ）. The most frequent adverse reactions were leukopenia and thrombocytopenia. Conclusions The available evidence suggests that the combination of 89SrCl2 and 99Tc-MDP is superior to 89SrCl2 alone for palliating bone pain and improving radionuclide bone scan and KPS scores in patients with bone metastases. However, these findings should be confirmed and extended in future studies.

关 键 词：骨肿瘤 骨转移瘤 核素治疗 氯化锶 锝-99-亚甲基二膦酸盐 META分析 

分 类 号：R195.1[医药卫生—卫生统计学]