紫杉醇联合顺铂经腹腔灌注与单纯静脉给药治疗晚期卵巢癌疗效的Meta分析  

Meta-analysis of the efficacy of paclitaxel combined with cisplatin in the treatment of advanced ovarian cancer by intraperitoneal perfusion and intravenous administration

作　　者：胡锦方 邢军 陈静思 何艳舫 HU Jinfang;XING Jun;CHEN Jingsi(Affiliated Hospital of North China University of Science and Technology,Tangshan 063000,China)

机构地区：[1]华北理工大学附属医院,河北唐山063000

出　　处：《华北理工大学学报（医学版）》2020年第2期119-129,共11页Journal of North China University of Science and Technology：Health Sciences Edition

摘　　要：①目的利用Meta分析对紫杉醇联合顺铂经腹腔灌注与单纯静脉给药治疗晚期卵巢癌的临床疗效、化疗后生存率及其对免疫调节作用的影响等方面进行对比分析。②方法计算机检索中国知网(CNKI)、万方、CMB中国生物医学库、Cochrane Library、Pubmed、Medline等数据库中所有关于紫杉醇联合顺铂不同给药途径治疗晚期卵巢癌疗效的随机对照文献,检索时限为2005年1月~2018年12月。根据排除、纳入标准筛选出符合本文要求的文献,依据观察指标提取相关数据,以Review Manager 5.3软件进行Meta分析。③结果本文共计纳入8篇相关随机对照研究,共794例患者,分为腹腔灌注组与静脉给药组,各397例。Meta分析结果表明化疗后疗效方面,两组的总有效率(OR=3.23,95%CI:2.23~4.47,P<0.05)、腹腔积液控制率(OR=3.32,95%CI:1.78~6.20,P<0.05)、CA125下降率(OR=4.43,95%CI:2.42~7.77,P<0.05),差异均有统计学意义,腹腔灌注组明显优于静脉给药组;生存率方面,两组的1年生存率(OR=3.69,95%CI:1.69~8.09,P<0.05)、2年生存率(OR=2.05,95%CI:1.23~3.40,P<0.05)、3年生存率(OR=1.83,95%CI:1.04~3.20,P<0.05)比较差异均有统计学意义,腹腔灌注组明显优于静脉给药组;免疫系统恢复方面,两组的CD4+CD25+(SMD=-0.43,95%CI:-0.88~0.02,P>0.05)、CD4+/CD8+(SMD=0.81,95%CI:-0.14~1.75,P>0.05)比较差异均无统计学意义;血液系统不良反应方面,两组患者的贫血(OR=0.72,95%CI:0.45~1.16,P>0.05)、白细胞减少(OR=0.75,95%CI:0.49~1.13,P>0.05)、血小板减少(OR=0.72,95%CI:0.48~1.07,P>0.05)发生率比较差异无统计学意义;非血液系统不良反应方面,两组的脱发(OR=0.83,95%CI:0.53~1.30,P>0.05)、恶心呕吐(OR=0.94,95%CI:0.66~1.33,P>0.05)、腹痛腹泻(OR=0.81,95%CI:0.54~1.21,P>0.05)、肌肉关节疼痛(OR=1.45,95%CI:0.80~2.63,P>0.05)、乏力(OR=0.86,95%CI:0.41~1.83,P=>0.05)、肝肾功能异常(OR=0.59,95%CI:0.28~1.24,P>0.05)、周围神经毒性(OR=1.22,95%CI:0.15~9.87,P>0.05)发生率比较差异Objective To analyze the clinical efficacy,clinical survival rate and immunomodulatory effects of paclitaxel combined with cisplatin in the treatment of advanced ovarian cancer with intraperitoneal perfusion and cisplatin.Methods A computer-based randomized controlled trial of paclitaxel plus cisplatin in the treatment of advanced ovarian cancer was performed in the Chinese Knowledge Network(CNKI),Wanfang,CMB China Biomedical Library,Cochrane Library,Pubmed,Science Direct,Medline and other databases.The search time was January 2005 to December 2018.According to the inclusion and exclusion criteria,the documents that met the requirements of this paper were selected,relevant data were extracted,and Meta analysis was performed with Review Manager 5.3 software.Results A total of 8 randomized controlled trials were included in this study.A total of 794 patients with distal radius fractures were divided into the peritoneal perfusion group and the intravenous administration group,with 397 patients each.The results of meta-analysis showed that after chemotherapy,the total effective rate of the two groups(OR=3.23,95%CI:2.23~4.47,P<0.05)and ascites control rate(OR=3.32,95%CI:1.78~6.20,P<0.05),CA125 decline rate(OR=4.43,95%CI:2.42~7.77,P<0.05)had statistically significant differences.The peritoneal perfusion group was significantly better than the intravenous infusion group.The survival rate was 1-year for the two groups.Survival rate(OR=3.69,95%CI:1.69~8.09,P<0.05),2-year survival rate(OR=2.05,95%CI:1.23~3.40,P<0.05),3-year survival rate(OR=1.83,95%CI:1.04~3.20,P<0.05).There was a statistically significant difference.The peritoneal perfusion group was significantly better than the intravenous perfusion group.In terms of immune system recovery,CD4+CD25+(SMD=-0.43,95%CI:-0.88~0.02,P>0.05),CD4+/CD8+(SMD=0.81,95%CI:-0.14~1.75,P>0.05 No statistically significant difference;blood system adverse reactions,anemia of the two groups(OR=0.72,95%CI:0.45~1.16,P>0.05),leukopenia(OR=0.75,95%CI:0.49~1.13,P>0.05),thrombocytopenia(OR=0.72,9

关 键 词：卵巢癌 META分析 紫杉醇联合顺铂 腹腔灌注 

分 类 号：R737.31[医药卫生—肿瘤]