重组人血管内皮抑素联合顺铂治疗恶性胸腔积液的Meta分析  

Efficacy and Safety of Recombinant Human Endostatin Combined with Cisplatin for Malignant Pleural Effusion:a Meta-analysis

作　　者：蒋俊[1] 解佳奇 张丽[1] 汪义纯[1] 权循凤[1] 

机构地区：[1]安徽医科大学第一附属医院,230022 [2]南京大学医学院附属鼓楼医院,210008

出　　处：《实用癌症杂志》2016年第3期411-416,共6页The Practical Journal of Cancer

基　　金：安徽省教育厅自然科学重点项目(编号:KJ2010A170)

摘　　要：目的系统评价重组人血管内皮抑素（Endostar）联合顺铂与单药顺铂胸腔内注射治疗恶性胸腔积液（MPE）的疗效及安全性。方法搜索Pubmed、Embase、CBM、CNKI、万方及维普数据库系统，检索关于重组人血管内皮抑素联合顺铂与单药顺铂治疗MPE的随机对照试验（RCT）。应用STATA12．0软件对数据进行Meta分析。结果总共纳入17篇RCT，总计1105例患者。Meta分析结果显示：重组人血管内皮抑素联合顺铂（联合组）的胸腔积液缓解率高于单药顺铂（观察组）（RR=1．623，95％CI=1．472～1．789；Z=9．71，P=0．000），联合组的KPS评分改善率高于观察组（RR：1．592，95％CI=1．422～1．782；Z=8．09，P=0．000）。在消化道不良反应方面，联合组发生率高于观察组（RR=1．204，95％CI=1．003～1．447；Z=1．99，P=0．047）。而肝肾毒性、骨髓抑制、发热、疲乏等不良反应的发生率两组比较差异无统计学意义（P〉0．05）。结论现阶段研究结果证明，重组人血管内皮抑素联合顺铂治疗MPE的疗效优于单药顺铂，不良反应较轻，安全性好，期待纳入更多高质量研究进一步分析。Objective To assess the efficacy and safety of recombinant human endostatin（Endostar） combined with cisplatin for malignant pleural effusion by conducting a meta-analysis. Methods A comprehensive collection of randomized controlled trials（RCTs） about Endostar combined with cisplatin versus single cisplatin in the treatment of malignant pleural effusion was retrieved from Pubmed,Embase, CBM, CNKI, Wanfang and VIP databases. Meta-analysis was conducted by STATA 12.0 software. Results 17 RCTs involving 1105 patients were identified in the study. The recta-analysis results showed that：Endostar combined with eisplatin（ combined group）had a higher hydrotborax total remission rate than single cisplatin （observation group） （ RR = 1. 623,95 % CI = 1. 472 - 1. 789 ; Z = 9.71 ,P = 0. 000） ; The KPS score in the combined group was better than that of the observation group（ RR = 1. 592,95% CI = 1. 422 - 1. 782 ;Z = 8.09 ,P = 0. 000） ;The incidence rate of gastrointestinal side effects in the combined group was higher than that of the observation group （RR = 1. 204,95% CI = 1. 003 - 1. 447;Z = 1.99, P = 0. 047 ） ; There was no significant difference in adverse reactions of liver and kidney toxieities, marrow suppression, heating and fatigue between the 2 groups （ P 〉 0.05 ）. Conclusion The current study shows that, Endostar combined with cisplatin for malignant pleural effusion is superior to single cisplatin therapy. The side reaction is mild, and the safety is identified. More high quality studies are expected to be further analyzed.

关 键 词：重组人血管内皮抑素 顺铂 恶性胸腔积液 META分析 

分 类 号：R734.3[医药卫生—肿瘤]