难治性甲状腺癌靶向治疗Meta分析  

Targeted therapies for refractory thyroid cancer:A Meta analysis

作　　者：王玉龙[1] 徐嘉[1] 陈鸿强[1] 袁凯[1] 周东升[1] 付荣湛[1] 

机构地区：[1]山东省千佛山医院乳腺甲状腺外科,山东济南250014

出　　处：《中华肿瘤防治杂志》2016年第4期266-271,共6页Chinese Journal of Cancer Prevention and Treatment

摘　　要：目的目前对于进展期甲状腺癌分子靶向治疗的研究多为单臂实验，RCT研究较少。本研究应用Meta分析方法，评价分子靶向治疗在难治性甲状腺癌中的疗效和安全性，以期为其应用提供理论基础。方法检索纳入1989—01—2015-01 Medline、Web of science、Cochrane Central、EBSCO、Embase等英文数据库及中国学术期刊全文数据库、万方、维普等中文数据库中的文献。按照纳入与排除标准进行文献筛选和质量评价后，利用Cochrane中心提供的RevMan5．0软件对数据进行分析。主要评价指标是患者的无进展生存率及药物的不良反应。结果共纳入4项随机对照试验研究，得到药物组总体样本730例，对照组（安慰剂组）总体样本493例。相比对照组，药物组6、12和18个月的无进展生存率均显著提高（6个月：RR=2．57，95％CI为1．97～3．35；12个月：RR=2．01，95％CI为1．53～2．65；18个月：RR=2．10，95％CI为1．54～2．87）。药物组不良反应发生率高于对照组（RR=4．20，95％CI为2．82～6．24）。主要是腹泻、疲劳、高血压、手足综合征和QT间期延长。结论靶向药物可显著延长难治性甲状腺癌患者的无进展生存期。虽然其不良反应发生率显著高于对照组，但患者仍可耐受。靶向治疗为难治性甲状腺癌患者带来新的希望。OBJECTIVE Most current studies on molecular targeting therapies for progressing thyroid cancer are single-arm studies, and randomized controlled trials （RCT） are rare. This study evaluated the effect and safety of molecular targeting therapy in refractory thyroid cancer with Meta analysis method, in order to provide theoretical basis for its application. METHODS Literature in English language databases including Medline, Web of science, Cochrane Central, EBSCO and Embase.dating from Jan. 1989 to Jan. 2015 were retrieved, Chinese language databases including Wanfang and Weipu were retrieved too. After screening and quality evaluating according to inclusion and exclusion criteria, data was analyzed with RevMan 5.0 software provided by Cochrane center. The primary evaluation criterion was progression free survival （PFS） and adverse effects of drugs. RESULTS Four RCTs were included. The total sample size of drug group was 730, and the sample size of control group （placebo group） was 493. Compared to control group, the progression free survival rates of drug group at 6 months, 12 months and 18 months were significantly higher （6 months： RR= 2.57,95GCI：1.97-3.35; 12 months： RR=2.01, 95GCI： 1.53-2.65;18 months： RR=2.10, 95%CI： 1.54-2.87）. The adverse effect rate was higher in drug group than that in control group （RR=4.20, 95%CI：2. 82-6. 24）. The most common adverse effects were diarrhea, fatigue, hypertension, hand-foot syndrome and prolonged QT interval. CONCLUSIONS Molecular targeting drugs can significantly extend the PFS of refractory thyroid cancer patients. Though the adverse effects rate is higher than that in controlled group, the most of them can be tolerated. Molecular targeting therapy can bring new hope for refractory thyroid cancer patients.

关 键 词：难治性甲状腺癌 靶向治疗 META分析 

分 类 号：R736.1[医药卫生—肿瘤]