第三代芳香化酶抑制剂内分泌治疗绝经后乳腺癌疗效的Meta分析  

A meta analysis of the efficacy of third generation aromatase inhibitors in endocrine therapy for postmenopausal breast cancer

作　　者：刘医辉 董春慧 陈玲[1] LIU Yi-hui ;; DONG Chun-hui ;; CHEN Ling .(Department of Oncology, Xi＇an Jiaotong University First Affiliated Hospital, Xi＇an Shaanxi 710061, China;Cancer center, Ningxia Hui Autonomous Region People＇s Hospital, Yinchuan Ningxia 750000, China; Department of Oncology, the Fifth Hospital of Xi＇an City, Xi＇an Shaanxi 710054, China)

机构地区：[1]西安交通大学第一附属医院肿瘤内科,陕西西安710061 [2]宁夏回族自治区人民医院肿瘤中心,宁夏银川750000 [3]西安市第九医院肿瘤内科,陕西西安710054

出　　处：《临床和实验医学杂志》2018年第21期2293-2296,共4页Journal of Clinical and Experimental Medicine

基　　金：陕西省科学技术研究发展计划项目(编号:2012KW-36-01)

摘　　要：目的系统评价第三代芳香化酶抑制剂辅助内分泌治疗绝经后乳腺癌患者的有效性及安全性。方法检索2015年12月之前在PubMed、The Cochrane Library、Medline、CNKI及万方等数据库已公开发表的,按既定标准纳入应用第三代芳香化酶抑制剂治疗绝经后妇女乳腺癌的随机对照试验,以Cochrane系统评价方法逐篇进行质量评价、资料提取,并采用Rev Man 5. 0软件进行统计分析。结果共纳入9项随机对照试验,共1 033例患者,其中试验组517例,对照组516例。Meta分析结果显示:对于有效性,依西美坦与阿那曲唑/来曲唑在临床缓解率方面无显著差异[OR=1. 22,95%CI(0. 94,1. 58),P=0. 13];对于安全性,依西美坦与阿那曲唑/来曲唑在潮热[OR=1. 18,95%CI(0. 80,1. 73),P <0. 05]、骨痛[OR=1. 62,95%CI(1. 05,2. 50),P <0. 05]方面差异有统计学意义;对于便秘的发生,依西美坦与阿那曲唑/来曲唑无显著差异性[OR=1. 52,95%CI(0. 88,2. 62),P=0. 13]。结论目前认为依西美坦与阿那曲唑/来曲唑在治疗绝经后乳腺癌患者临床缓解率方面无显著差异,潮热骨痛的发生依昔美坦较阿那曲唑/来曲唑明显。Objective To systematically evaluate the efficacy and safety of third-generation aromatase inhibitor assisted endocrine therapy in postmenopausal women with breast cancer. Methods The randomized controlled trials （RCT） had been published in PubMed, The Cochrane Library, Medline, CNKI and Wanfang databases before December 2015 for the treatment of breast cancer in postmenopausal women using established third-generation aromatase inhibitors according to established criteria. Cochrane systematic reviews were used to assess quality and extract data. Meta-analysis was carried out using RevMan 5.0 software. Results 9 RCTs were enrolled in this study. A total of 1033 patients were included, of which 517 were in the experimental group and 516 in the control group. Meta-analysis showed there was no significant difference in clinical response rates between exemestane and anastrozole / letrozole for efficacy （OR=1.22, 95%CI, 0.94, 1.58; P =0.13）. For safety, exemestane and anastrozole / letrozole in hot flashes [OR=1.18, 95%CI 0.80, 1.73, P 〈0.05], bone pain [OR=1.62, 95%CI 1.05, 2.50）, P 〈0.05] had improved significantly. There was no significant difference between exemestane and anastrozole / letrozole for the occurrence of constipation [OR=1.52, 95%CI （0.88, 2.62）, P =0.13]. Conclusion The clinical response rate is currently no significant difference between exemestane and anastrozole / letrozole in the treatment of patients with postmenopausal breast cancer. There is a higher incidence of hot flashes and bone pain with exemestane compared with anastrozole / letrozole.

关 键 词：乳腺癌 芳香化酶抑制剂 随机对照试验 META分析 

分 类 号：R737.9[医药卫生—肿瘤]