晚期大肠癌重组人血管内皮抑制素联合化疗近期疗效和安全性Meta分析  

Short-term therapeutic effect of recombinant human edostatin combined with chemotherapy for advanced colorectal carcinoma:a Meta-analysis

作　　者：赖军明 罗辉[2] 林红[2] 胡爽 LAI Jun-ming;LUO Hui;LIN Hong;HU Shuang(Medicine Department of Graduate School of Nanchang University, Nan Chang 330006, P. R. China;Department of Oncology , First Affiliated Hospital of Nanchang University, Nanchang 330006, P. R. China;Department of Oncology, No. 171 Hospital of PLA ,Jiujiang 332000 ,P. R. China)

机构地区：[1]南昌大学研究生院医学部,江西南昌330006 [2]南昌大学第一附属医院肿瘤科,江西南昌330006 [3]中国人民解放军第一七一医院肿瘤科,江西九江332000

出　　处：《中华肿瘤防治杂志》2017年第22期1604-1610,共7页Chinese Journal of Cancer Prevention and Treatment

摘　　要：目的抗血管生成治疗已成为肿瘤治疗中最有效手段之一,本研究为系统评价重组人血管内皮抑制素(recombinant human endostatin,rhES,商品名:恩度)联合化疗治疗晚期大肠癌的近期疗效和安全性。方法计算机检索Pubmed、Elsevier、Cochrane Library、中国生物医学文献数据库(CBM)、中国知网(CNKI)和万方数据数据库,筛选有关rhES联合化疗治疗晚期大肠的随机对照试验,检索年限均为从建库至2017-02。使用修改后的Jadad量表对文献进行评价后提取数据,使用RevMan5.3软件进行Meta分析,计算相对危险度(relative risk,RR)及95%可信区间(confidence interval,CI)。结果最终纳入15个对照试验,共计901例晚期大肠癌患者纳入研究。Meta分析结果显示,与单纯化疗组相比,rhES联合化疗组的完全缓解(complete response,CR)率(RR=2.48,95%CI为1.45~4.23,P=0.0 008)、部分缓解(partial response,PR)率(RR=1.33,95%CI为1.13~1.56,P=0.0 006)、疾病进展(progressive disease,PD)率(RR=0.46,95%CI为0.36~0.60,P<0.001)、有效率(response rate,RR)(RR=1.51,95%CI为1.30~1.75,P<0.001)、疾病控制率(disease control rate,DCR)(RR=1.25,95%CI为1.16~1.34,P<0.001)方面均显示出优势。常见不良反应中的骨髓抑制(RR=1.09,95%CI为0.93~1.27,P=0.28)、胃肠道反应(RR=1.04,95%CI为0.84~1.28,P=0.72)、心脏毒性(RR=3.64,95%CI为0.80~16.54,P=0.09)的两组差异均无统计学意义。结论 rhES联合化疗治疗晚期大肠癌的近期疗效优于单纯化疗,且常见的不良反应未增加。OBJECTIVE Antiangiogenic therapy has become one of the most effective methods for patients with cancer.This Meta-analysis evaluates the short-term therapeutic effect and safety of recombinant human edostatin（Endostar）combined with chemotherapy in the treatment of advanced colorectal carcinoma.METHODS The relevant randomized controlled trials about Endostar combined with chemotherapy in the treatment of advanced colorectal carcinoma were retrieved from the databases of Pubmed,Elsevier,Cochrane Library,China National Knowledge Infrastructure（CNKI）,Chinese BioMedical Literature Database（CBM）and Wan Fang Database.The retrieval time limited was from the database construction to February 2017.Quality of the studies was assessed using modified Jadad scale.After data extraction,a Meta-analysis was performed by using RevMan5.3 software.Relative risk（RR）and 95% confidence interval（CI）were calculated.RESULTS Fifteen controlled trials were included in this Meta-analysis including 901 patients.The results showed that Endostar combined with chemotherapy had an overall advantage over chemotherapy alone in terms of complete response（CR）rate（RR=2.48,95%CI：1.45-4.23,P=0.0 008）,partial response（PR）rate（RR=1.33,95%CI：1.13-1.5,P=0.0 006）,progressive disease（PD）rate（RR=0.46,95%CI：0.36-0.60,P〈0.001）,response rate（RR）（RR=1.51,95%CI：1.30-1.75,P〈0.001）,disease control rate（DCR）（RR=1.25,95%CI：1.16-1.34,P〈0.001）.Meanwhile,Myelosuppression（RR=1.09,95%CI：0.93-1.27,P=0.28）,Gastrointestinal reaction（RR=1.04,95%CI：0.84-1.28,P=0.72）,cardiotoxicity（RR=1.04,95%CI：0.84-1.28,P=0.72）were no statistically significant differences in the common adverse reactions.CONCLUSION This Meta-analysis indicates that recombinant human edostatin combined with chemotherapy has better short-term therapeutic effect on advanced colorectal carcinoma,and the common adverse events do not increase in comparison with chemotherapy alone.

关 键 词：重组人血管内皮抑制素 晚期 结直肠癌 META分析 

分 类 号：R735.34[医药卫生—肿瘤]