阿帕替尼治疗晚期卵巢癌疗效与安全性的Meta分析  

Efficacy and safety of apatinib in the treatment of advanced ovarian cancer:a meta-analysis

作　　者：徐翔 叶明侠[2] 赵恩锋[2] 李立安[2] 孟元光[2] Xu Xiang;Ye Mingxia;Zhao Enfeng(Chinese PLA General Hospital,Beijing 100853,China)

机构地区：[1]解放军医学院,北京100853 [2]解放军总医院第七医学中心妇产医学部

出　　处：《中华保健医学杂志》2021年第6期634-637,共4页Chinese Journal of Health Care and Medicine

基　　金：解放军总医院大数据项目(2018MBD-021)。

摘　　要：目的探讨阿帕替尼治疗晚期卵巢癌的疗效与安全性。方法检索常用的中英文数据库,收集自建库至2021年5月发表的关于阿帕替尼治疗晚期卵巢癌的随机对照研究。对纳入文献进行筛选与偏倚风险分析后,利用Rev Man5.3软件进行Meta分析。结果共纳入11篇文献681例晚期卵巢癌患者。试验组(联合阿帕替尼)与对照组(单纯化疗组)对比分析得出,前者可延长无进展生存期(PFS)3.62个月及总生存期(OS)5.21个月(95%CI=1.36~5.87,3.01~7.42,P<0.05);可提高客观缓解率(ORR)(OR=3.40,95%CI=2.43~4.76,P<0.05)及疾病控制率(DCR)(OR=3.21,95%CI=2.25~4.58,P<0.05)。常见不良反应中,试验组仅高血压(OR=3.11,95%CI=1.44~6.74,P=0.004)、手足综合征(OR=3.08,95%CI=1.72~5.51,P=0.0001)及蛋白尿(OR=2.69,95%CI=1.13~6.39,P=0.03)的发生率高于对照组,其余胃肠道反应、白细胞减少等不良反应的发生率在两组间差异无统计学意义(P>0.05)。结论阿帕替尼可延长晚期卵巢癌患者的PFS、OS,提高ORR与DCR,可能会增加高血压、手足综合征、蛋白尿的发生率,但胃肠道、血液系及其他不良反应的发生率与常规化疗相当。Objective To investigate the efficacy and safety of apatinib in the treatment of advanced ovarian cancer.Methods The commonly used English and Chinese databases were searched for the randomized controlled trials of apatinib in the treatment of advanced ovarian cancer published from the establishment of the database to May 2021.After screening the included literature and analyzing the risk of bias,the Rev Man5.3 software was used to conduct a meta-analysis.Results A total of 681 patients with advanced ovarian cancer were included in 11 articles.A comparative analysis of the experimental group(combined with apatinib)and the control group(chemotherapy alone)showed that the former can prolong the progression-free survival(PFS)by 3.62 months(95%CI=1.36-5.87,P<0.05)and the survival time(OS)is 5.21 months(95%CI=3.01-7.42,P<0.05),and can improve the objective response rate(ORR)(OR=3.40,95%CI=2.43-4.76,P<0.05)and disease control rate(DCR)(OR=3.21,95%CI=2.25-4.58,P<0.05).Among the common adverse reactions,the incidence of the hypertension(OR=3.11,95%CI=1.44-6.74,P=0.004),hand-foot syndrome(OR=3.08,95%CI=1.72-5.51,P=0.0001)and urine protein(OR=2.69,95%CI=1.13-6.39,P=0.03)in experimental group was higher than that in the control group.While the analyses of other adverse events,such as gastrointestinal reactions and leukopenia did not reveal significant differences(P>0.05).Conclusion Apatinib can prolong the PFS and OS,increase ORR and DCR,and may increase the incidence of hypertension,hand-foot syndrome,proteinuria in patients with advanced ovarian cancer.But the incidence rate of gastrointestinal,hematological and other adverse reactions is comparable to that of conventional chemotherapy.

关 键 词：阿帕替尼 晚期卵巢癌 META分析 随机对照试验 

分 类 号：R737[医药卫生—肿瘤]