联合^(89)锶治疗前列腺癌骨相关事件有效性及安全性Meta分析  

Efficacy and Safety of Combined Therapy with ^(89)Sr in Skeletal-Related Events of Prostate Cancer:A Meta-analysis

作　　者：李亮亮 任小强[1] 徐自然 辛士永[1] 张建国[1] LI Liangliang;REN Xiaoqiang;XU Ziran;XIN Shiyong;ZHANG Jianguo(Department of Urology,the First Affiliated Hospital,Henan University of Science and Technoloy,Luoyang 471003,China;College of Clinical Medicine,Henan University of Science and Technoloy,Luoyang 471003,China)

机构地区：[1]河南科技大学第一附属医院泌尿外科,洛阳471003 [2]河南科技大学临床医学院,洛阳471003

出　　处：《医药导报》2017年第12期1404-1410,共7页Herald of Medicine

摘　　要：目的系统评价联合放射性核素^(89)锶(Sr)治疗前列腺癌骨相关事件的有效性及安全性。方法计算机检索Pub Med、MEDLINE、EMBASE、Cochrane图书馆、CNKI、CBM及万方数据库等,检索时间从1976年^(89)Sr首次报道应用至2015年9月,语种限制为中文、英语。纳入联合^(89)Sr治疗(试验组)对比非联合(对照组)治疗前列腺癌的随机对照试验,对符合纳入标准的临床研究进行资料提取和质量评价后,采用Rev Man5.2版统计软件进行Meta分析。结果最终纳入18项RCT研究,共计1 280例患者。Meta分析结果显示:两组患者在疼痛缓解率[OR=4.71,95%CI(3.34,6.62),P<0.000 1]、骨转移灶减少率[OR=3.63,95%CI(2.60,5.09),P<0.000 1]和生活质量改善率[OR=2.16,95%CI(1.16,4.02),P<0.05]方面差异有统计学意义。试验组患者的无进展生存期显著长于对照组,差异有统计学意义[HR=0.84,95%CI(0.73,0.97),P=0.02],总生存期[HR=0.82,95%CI(0.65,1.02),P=0.07]与对照组比较,差异无统计学意义。两组患者不良反应差异无统计学意义[OR=1.46,95%CI(0.98,2.17),P>0.05]。结论联合放射性核素^(89)Sr治疗前列腺癌骨相关事件的效果优于非联合治疗组,在患者不良反应发生率方面无明显差异,安全性较好。但本研究受纳入研究质量和样本量限制,该结论尚需更多高质量、长期随访的大样本RCT加以验证。ObjectiveTo evaluate the efficacy and safety of combined therapy with89Sr for treating skeletal related events of prostate cancer.MethodsDatabases including PubMed,MEDLINE,EMBASE,the Cochrane library,CNKI,CBM and Wanfang were systematically searched since89Sr was first reported in1976to September2015to include the randomized controlled trials(RCTs)of the combined therapy with89Sr for skeletal related events of prostate cancer.The statistical analysis was performed using Review Manager Version5.2.ResultsA total of18RCTs involving1280patients were analyzed.The results of meta analysis indicated:there were statistically significant differences in the pain relief rate[OR=4.71,95%CI(3.34,6.62),P<0.0001],decrement rate of bone metastasis[OR=3.63,95%CI(2.60,5.09),P<0.0001]and improvement rate of life quality[OR=2.16,95%CI(1.16,4.02),P<0.05].Progression free survival of patients in experimental group was significantly longer than that in control group[HR=0.84,95%CI(0.73,0.97),P=0.02].No significant difference was found in overall survival[HR=0.82,95%CI(0.65,1.02),P=0.07].There were no significant differences in the incidence of adverse events[OR=1.46,95%CI(0.98,2.17),P>0.05].ConclusionCombined therapy with89Sr has better efficacy and comparable safety profile compared with standard therapy.However,the quality and sample size of the included studies are limited,so more high quality and large sample RCTs are needed to verify the validity.

关 键 词：89锶 癌 前列腺 骨相关事件 系统评价 对照试验 随机 

分 类 号：R969.3[医药卫生—药理学] R737.25[医药卫生—药学]