5-羟色胺受体拮抗剂预防放疗相关恶心和呕吐Meta分析  

Efficacy of 5-HT3 receptor antagonists in preventing radiotherapy nausea and vomiting:A Meta-analysis

作　　者：吕杰[1] 彭进[1] 王万伟[1] 朱卫国[1] 岳顺[2] 于春杨[3] Lü Jie;PENG Jin;WANG Wan-wei;ZHU Wei-guo;YUE Shun;YU Chun-yang(Affiliated Huaian First People's Hospital of Nanjing Medical University,Huai'an 223000,P.R.China)

机构地区：[1]南京医科大学附属淮安第一医院放疗科,江苏淮安223000 [2]南京医科大学附属淮安第一医院肿瘤科,江苏淮安223000 [3]南京医科大学附属淮安第一医院心内科,江苏淮安223000

出　　处：《中华肿瘤防治杂志》2019年第18期1387-1393,共7页Chinese Journal of Cancer Prevention and Treatment

摘　　要：目的放疗是目前治疗恶性肿瘤的重要方式,恶心和呕吐是肿瘤患者放疗过程中常见的不良反应之一,频繁、剧烈的恶心呕吐会导致食物摄入障碍,引起水电解质紊乱和营养不良,降低患者放疗依从性和疗效。5-羟色胺(5-hydroxy tryptamine,5-HT)3受体拮抗剂是预防恶心和呕吐的一线药物。本研究旨在系统评价5-HT3受体拮抗剂预防放疗相关性恶心呕吐(radiotherapy induced nausea and vomiting,RINV)有效性。方法检索PubMed、Cochrane图书馆、EMbase、CNKI、CBM、VIP及万方等数据库。时间选择自建库至2018-01公开发表的接受5-HT3受体拮抗剂及其他止吐药预防,包括腹部、盆腔以及全身放疗引起的恶心及呕吐的所有随机对照试验(randomized controlled trials,RCTs)。按照纳入标准和排除标准进行文献筛选,质量评估及资料提取,应用RevMan 5.35软件进行Meta分析。主要完成终点是急性期和延迟期完全控制的恶心和完全控制的呕吐。结果共纳入6个RCTs,738例患者。Meta分析结果显示,5-HT3受体拮抗剂控制急性期呕吐方面明显优于安慰剂组,RR=0.69,95%CI:0.56~0.85,P=0.000 5;5-HT3受体拮抗剂较多巴胺受体拮抗剂控制呕吐有显著优势,RR=0.29,95%CI:0.08~0.77,P=0.000 3。5-HT3受体拮抗剂完全控制急性期恶心明显优于安慰剂组,RR=0.83,95%CI:0.75~0.93,P=0.000 7;5-HT3受体拮抗剂较多巴胺受体拮抗剂完全控制急性期恶心有显著优势,RR=0.78,95%CI:0.66~0.92,P=0.03。结论 5-HT3受体拮抗剂能显著缓解放疗相关性恶心和呕吐,且较多巴胺受体拮抗剂预防RINV更有效。OBJECTIVE Radiotherapy is currently important means of treating malignant tumors.Nausea and vomiting are the common side effects during radiotherapy in patients with cancer.Frequent and severe nausea and vomiting can lead to mistakes intake,causing water and electrolyte disorders and malnutrition,and reducing radiotherapy compliance and efficacy.5-HT3 receptor antagonist is a first-line drug for preventing nausea and vomiting.This study aimed to explore the effectiveness of 5-HT3 receptor antagonists in preventing radiotherapy nausea and vomiting.METHODS We electronically searched the following databases including PubMed,Cochrane,Medline,EMbase,CBM,CNKI,VIP and WanFang Database to collect randomized controlled trials(RCTs)from the time of contribution to January,2018 about 5-HT3 receptor antagonists in preventing radiotherapy nausea and vomiting for patients receiving radiotherapy to abdomen/pelvis/total body.Two reviewers independently screened 1 iterature according to the inclusion and exclusion criteria,extracted data and assessed the quality of the included studies.Meta-analysis was Performed by using RevMan 5.35 software.RESULTS A total of 6 RCTs involving 738 patients were included.The results showed that prophylaxis with a 5-hydroxytryptamine-3 receptor antagonist(5-HT3 RA)was significantly higher than that with placebo in vomiting(RR=0.69,95%CI:0.56-0.85,P=0.000 5).The results showed that prophylaxis with a 5-HT3 RA was significantly more higher than that with dopamine receptor antagonists in vomiting(RR=0.29,95%CI:0.08-0.77;P=0.000 3).The results showed that prophylaxis with 5-HT3 RA was significantly higher than that with placebo in nausea(RR=0.83;95%CI:0.75-0.93;P=0.000 7).The results showed that prophylaxis with a 5-HT3 RA was significantly higher than that with dopamine receptor antagonists in nausea(RR=0.78;95%CI:0.66-0.92;P=0.03).CONCLUSIONS 5-HT3 RAs are more effective than other antiemetics for prophylaxis of RINV in patients receiving radiotherapy to abdomen/pelvis.5-HT3 RAs can significantly re

关 键 词：放疗相关性恶心和呕吐 5-羟色胺受体拮抗剂 急性完全控制缓解 META分析 随机对照试验 

分 类 号：R73[医药卫生—肿瘤]