紫衫烷类与蒽环类药物用药顺序不同对乳腺癌新辅助化疗疗效影响的meta分析  

Influence of different medication sequences of taxanes and anthracyclines on efficacy of neoadjuvant chemotherapy for breast cancer:a meta analysis

作　　者：邱佳 丁波泥[1] 钱立元[1] 吴唯[1] 文言广[1] QIU Jia;DING Boni;QIAN Liyuan;WU Wei;WEN Yanguang(Department of Breast and Thyroid Surgery,Third Xiangya Hospital of Central South University,Changsha,Hunan 410013,China)

机构地区：[1]中南大学湘雅三医院乳甲外科,长沙410013

出　　处：《重庆医学》2021年第21期3720-3725,共6页Chongqing medicine

摘　　要：目的探讨紫衫烷类与蒽环类药物用药顺序不同对乳腺癌新辅助化疗患者疗效的影响。方法检索Pubmed、Cochrane、Embase、中国知网(CNKI)、万方医学网等数据库,收集符合纳入标准的研究。按纳入及排除标准由2名研究人员独立进行筛选、提取相关数据及质量评价。以5年总生存率(OS)、5年无病生存率(DFS)、病理完全缓解率(PCR)、保乳率、客观缓解率(ORR)、疾病控制率(DCR)及3~4级不良反应发生率作为观察指标。采用Revman5.3软件进行meta分析。结果最终纳入符合标准的相关文献10篇,累计样本量1956例。先使用紫衫烷类药物再使用蒽环类药物(T→A组)患者OS、DFS、PCR、ORR、DCR、保乳率与先使用蒽环类再使用紫衫烷类药物(A→T组)比较,差异均无统计学意义(P>0.05)。在3~4级不良反应中T→A组患者更易发生白细胞减少,差异有统计学意义(P=0.00001);两组患者其余3~4级不良反应比较,差异均无统计学意义(P>0.05)。结论乳腺癌新辅助化疗可考虑A→T的给药顺序。Objective To investigate the influence of the different administration sequences of taxanes and anthracyclines on the therapeutic effect of neoadjuvant chemotherapy for breast cancer.Methods The PubMed,Cochrane Library,Embase,CNKI and WanFang databases were retrieved for collecting the studies meeting the inclusion standard.The two researchers independently screened according to the inclusion and exclusion standard,extracted the related data and conducted the quality evaluation.The 5-year overall survival(OS),5-year disease-free survival(DFS),pathological complete response(PCR)rate,breast conservation rate,objective response rate(ORR),disease control rate(DCR),and occurrence rate of grade 3-4 adverse reactions served as the observation indicators.The Revman 5.3 software was used to conduct the meta analysis.Results Ten related literatures meeting the standard were included with a accumulative sample amounts of 1956 cases.There was no statistically significant difference in OS,DFS,PCR,ORR,DCR and breast conservation rate between the patients with taxanes first and then anthracyclines(T→A)and those with anthracyclines first and then taxanes(A→T).In the grade 3-4 adverse reactions,the T→A group was more prone to leukopenia(P=0.00001),and the difference was statistically significant(P=0.00001);there was no statistical difference in the incidence rate of other grade 3-4 adverse reactions between the two groups(P>0.05).Conclusion The neoadjuvant chemotherapy of breast cancer is considered to take the A→T administration sequence.

关 键 词：乳腺肿瘤 新辅助化疗 紫衫烷类药物 蒽环类药物 用药顺序 META分析 

分 类 号：R737.9[医药卫生—肿瘤]