重组人腺病毒P53联合放疗和单独放疗治疗中晚期恶性肿瘤有效性和安全性的Meta分析  

Meta-analysis of the effectiveness and safety of recombinant human adenovirus P53 combined with radiotherapy and radiotherapy alone in the treatment of advanced malignant tumors

作　　者：和庆章 王桂良 谭松龄 邱萍 徐林芳 龚敏 付云辉 韩明 文剑波[1] HE Qingzhang;WANG Guiliang;TAN Songling;QIU Ping;XU Linfang;GONG Min;FU Yunhui;HAN Ming;WEN Jianbo(Department of Gastroenterology,Affiliated Pingxiang Hospital of Gannan Medical University,Pingxiang337000,China)

机构地区：[1]赣南医学院附属萍乡医院消化内科,江西萍乡337000

出　　处：《中国现代医生》2021年第33期96-101,共6页China Modern Doctor

基　　金：江西省卫生计生委科技计划(20177194)。

摘　　要：目的分析重组人腺病毒P53(rHAd-P53)联合放疗和单独放疗治疗中晚期恶性肿瘤有效性和安全性。方法在Science Citation Index(SCI)、Corhrane Library、Embase、Pubmed、万方数据(WANFANG DATA)、中国知网[Chinese National Knowledge Infrastructure(CNKI)]、VIP[Database for Chinese Technical Periodical(VIP)]中进行系统检索文献,收集rHAd-P53联合放疗和单独放疗治疗中晚期恶性肿瘤的随机对照试验(RCT),制订文献纳入与排除标准,筛选文献后一共纳入了8篇研究,对入选文献提取数据,采用Review Manager统计软件对数据进行分析。结果与单纯放疗组相比,rHAd-P53联合放疗的完全缓解率(RR=2.53,95%CI:1.79~3.56,P<0.001)和有效率(RR=1.42,95%CI:1.08~1.85,P<0.05)均显著性升高;部分缓解率(RR=0.93,95%CI:0.61~1.42,P=0.74)和受益率(RR=1.02,95%CI:0.98~1.06,P>0.05)无显著性差异;低热发生率(RR=10.57,95%CI:4.79~23.33,P<0.001)和注射部位疼痛发生率(RR=41.00,95%CI:8.39~200.24,P<0.001)显著性增加;骨髓抑制发生率(RR=0.71,95%CI:0.42~1.19,P>0.05)、放射性膀胱炎发生率(RR=1,95%CI:0.34~2.95,P>0.05)和放射性肠炎发生率(RR=0.91,95%CI:0.42~1.96,P>0.05)无显著性差异。结论rHAd-P53联合放疗和单独放疗均是治疗中晚期恶性肿瘤的有效方法,rHAd-P53可增加放疗的敏感性,提高治疗效果,而未明显增加副反应。Objective To analyze the effectiveness and safety of recombinant human adenovirus P53(rHAd-P53)combined with radiotherapy and radiotherapy alone in the treatment of advanced malignant tumors.Methods The systematic literature search was conducted in Science Citation Index(SCI),Corhrane Library,Embase,Pubmed,WANFANG DATA,Chinese National Knowledge Infrastructure(CNKI),Database for Chinese Technical Periodical(VIP),in order to collect randomized controlled trials(RCTs)of rHAd-P53 combined radiotherapy and radiotherapy alone in the treatment of advanced malignant tumors.According to the formulated literature inclusion and exclusion criteria,a total of 8 studies were included after the screening of the literature.Data was extracted from the selected literature,and then analyzed by the statistical software Review Manager.Results The complete response rate(RR=2.53,95%CI:1.79-3.56,P<0.001)and effective rate(RR=1.42,95%CI:1.08-1.85,P<0.05)in the group of rHAd-P53 combined with radiotherapy were significantly higher than the group of radiotherapy alone;there were no statistical differences in the partial response rate(RR=0.93,95%CI:0.61-1.42,P=0.74)and benefit rate(RR=1.02,95%CI:0.98-1.06,P>0.05)between the two groups;the incidence of low fever(RR=10.57,95%CI:4.79-23.33,P<0.001)and the incidence of pain at the injection site(RR=41.00,95%CI:8.39-200.24,P<0.001)in the group of rHAd-P53 combined with radiotherapy were significantly higher than those in the group of radiotherapy alone;there were no statistical differences in the incidences of bone marrow suppression(RR=0.71,95%CI:0.42-1.19,P>0.05),radiation cystitis(RR=1,95%CI:0.34-2.95,P>0.05)and radiation enteritis(RR=0.91,95%CI:0.42-1.96,P>0.05)between the two groups.Conclusion Both rHAd-P53 combined radiotherapy and radiotherapy alone are effective methods for the treatment of advanced malignant tumors.However,rHAd-P53 can increase the sensitivity of radiotherapy and improve the therapeutic effect without significantly increasing the side effects.

关 键 词：重组腺病毒P53 放射治疗 中晚期恶性肿瘤 有效性 安全性 

分 类 号：R96[医药卫生—药理学] R73[医药卫生—药学]