尼达尼布对肿瘤患者胃肠道副反应及肝毒性作用的Meta分析  

Risk of Gastrointestinal and Hepatic Toxicities Treated with Nintedanib in Cancer Patients: A Meta Analysis

作　　者：方芳[1] 李雪 

机构地区：[1]核工业四一六医院,四川成都610051

出　　处：《四川医学》2017年第8期917-920,共4页Sichuan Medical Journal

摘　　要：目的系统评价尼达尼布治疗肿瘤患者时的胃肠道副反应和肝毒性风险。方法计算机检索Cochrane database,pubmed,embase,Web of sciences和CNKI等相关数据库,收集尼达尼布治疗肿瘤的临床随机对照研究,纳入标准为描述了腹泻、呕吐、ALT和AST转氨酶升高等不良事件的相关研究。结果本研究共纳入5项RCT,其中4项为安慰剂对照,1项为贝伐单抗对照。5项研究均报道了所有级别和严重级别腹泻、呕吐、ALT转氨酶升高发生率,其中4项研究报道了AST转氨酶升高发生率。与安慰剂相比,尼达尼布所有级别不良反应和严重级别不良反应发生率均较高,而严重不良反应发生率,尼达尼布组更高。与贝伐单抗相比,差异无统计学意义(P>0.05)。结论肿瘤患者在使用尼达尼布时发生胃肠道副反应和肝毒性的风险明显升高,提示在临床治疗时,需要对患者的胃肠道功能和肝功能进行实时检测和观察。Objective to investigate the risk of gastrointestinal and hepatic toxicities in cancer patients treated with nintedanib.Methods A search was conducted in databases including Cochrane database,pubmed,embase,Web of science and CNKI database for randomized controlled trials of cancer patients treated with nintedanib; describing events of diarrhea,vomiting,elevated ALT and elevated AST constituted the eligible studies. Results A total of 5 studies wereincluded. 4 of them were compared with placebo while the other one was compared with bevacizumab.All of these included studies reported the all-grade and high-grade of diarrhea,vomiting,elevated ALT while 4 of them reported the all grade and high grade of vlevated AST.Results showed that as compared with placebo,the OR of nintedanib for all-grade and high-gradegastrointestinal and hepatic toxicities were significantly higher; no significant difference was found between nintedanib and bevacizumab.Conclusion The risk of gastrointestinal and hepatic toxicities increases significantly in patients treated with nintedanib,which suggests that the real-time detection and observation on the patients＇ function should be performed during the treatment.

关 键 词：尼达尼布 胃肠道副反应 肝毒性 META分析 

分 类 号：R730.5[医药卫生—肿瘤]