国内吉西他滨与吡柔比星膀胱灌注有效性和安全性的Meta分析  

Efficiency and Safety of Gemcitabine Versus Pirarubicin Bladder Irrigation in China:a Meta-analysis

作　　者：胡俊丹 胡云飞[2] HU Jundan;HU Yunfei(Department of Urology Surgery,Xishui Hospital Affiliated to Hubei University of Science and Technology,Xishui Hubei 438200,China;Urology Surgery Department,Renmin Hospital of Wuhan University,Wuhan Hubei 430060,China)

机构地区：[1]湖北科技学院附属浠水医院泌尿外科,湖北浠水438200 [2]武汉大学人民医院泌尿外科,湖北武汉430060

出　　处：《中国继续医学教育》2020年第25期155-159,共5页China Continuing Medical Education

摘　　要：目的对国内吉西他滨与吡柔比星膀胱灌注预防膀胱癌复发两种方式的有效性和安全性进行系统评价。方法系统检索中国知网(CNKI)、中国生物医学文献数据库(CBM)、维普中文科技期刊数据库(VIP)、万方中国学术期刊数据库(CSPD),并辅以人工检索,检索时间均为建库至2019年10月,查找所有研究比较吉西他滨(GEM)与吡柔比星(THP)膀胱灌注预防膀胱癌复发的对照试验,按纳入排除标准由两人独立进行筛选、资料选取和质量评价,采用Revman 5.3软件进行Meta分析。结果共纳入12项研究。Meta分析结果显示:与吡柔比星膀胱灌注相比,吉西他滨膀胱灌注明显减少了膀胱癌电切术后复发率和膀胱刺激征发生率(P<0.05),而在不良反应发生率和血尿发生率二者差异无统计学意义,P>0.05。结论吉西他滨与吡柔比星膀胱灌注预防膀胱癌复发是安全有效的治疗方式。吉西他滨与吡柔比星膀胱灌注相比,在膀胱癌电切术后复发率和膀胱刺激征发生率存在优势,而在不良反应发生率和血尿发生率并无明显差异。但由于该Meta分析纳入研究仅在国内,数量少,有存在选择偏倚、实施偏倚与发表偏倚的可能性,需要更多高质量、大样本的随机对照试验提供更可靠的循证医学证据。Objective To systematically review the clinical therapeutic efficacy and safety of gemcitabine and pirarubicin in prevention of recurrence of bladder tumor in China.Methods We searched CNKI,CBM,VIP and CSPD without from their establishment to October 2019 for collecting the controlled trials about gemcitabine and pirarubicin in prevention of recurrence of bladder tumor in China,and the references of those controlled trials were also searched by hand.After study selection,assessment and data extraction conducted by two reviewers independently,Cochrane Collaboration’s RevMan 5.3 software was used for statistical analysis.Results Twelve studies were included.Meta-analysis showed that gemcitabine is better than pirarubicin in prevention of recurrence of bladder tumor and incidence of bladder irritation(P<0.05),but no significant difference was found with regard to adverse reaction rate,incidence of hematuria,P>0.05.Conclusion Gemcitabine and pirarubicin bladder irrigation is a safe and effective method in prevention of recurrence of bladder tumor.Compared with pirarubicin,gemcitabine could reduce recurrence rate of bladder tumor and incidence of bladder irritation,without reducing adverse reaction rate and incidence of hematuria.Because of the small number of the included studies,which weakens the strength of the evidence of our results,there is a moderate possibility of selection bias,performance bias and publication bias in this Meta-analysis.More high-quality and large-sample studies are needed to provide further evidences in Evidence-based medicine.

关 键 词：吉西他滨 吡柔比星 膀胱灌注 膀胱癌 复发 META分析 

分 类 号：R737.14[医药卫生—肿瘤]