重组人p53腺病毒注射液联合放疗或同步放化疗治疗宫颈癌疗效及安全性的Meta分析  

The efficacy and safety of recombinant human adenovirus-p53 combined with radiotherapy or chemoradiotherapy for cervical cancer:A Meta-analysis

作　　者：郭亚茹 许明娜 方苗 杨松 辛勇 GUO Yaru;XU Mingna;FANG Miao;YANG Song;XIN Yong(Department of Radiation,the Affiliated Hospital of Xuzhou Medical University,Jiangsu Xuzhou 221000,China)

机构地区：[1]徐州医科大学附属医院肿瘤放射治疗科,江苏徐州221000

出　　处：《现代肿瘤医学》2022年第14期2584-2590,共7页Journal of Modern Oncology

基　　金：江苏省人社厅第十四批“六大人才高峰”高层次人才项目资助课题(编号:WSN-121)。

摘　　要：目的:系统评价重组人p53腺病毒注射液(recombinant human adenovirus-p53,rAd-p53)联合放疗或同步放化疗治疗宫颈癌的疗效及安全性。方法:在中国知网、万方、中国生物医学文献数据、维普、PubMed、EMBase、The Cochrance of Library、Web of Science等数据库中检索关于rAd-p53联合放疗或同步放化疗治疗宫颈癌的随机对照实验,检索日期截至2021年02月。对纳入的文献进行数据提取与质量评价后,使用RevMan 5.3软件进行Meta分析。结果:共纳入10篇文献,共487例患者。Meta分析结果显示:rAd-p53联合放疗或同步放化疗组的完全缓解(complete response,CR)率[OR=2.45,95%CI(1.63,3.68),P<0.0001]、客观缓解率(objective response rate,ORR)[OR=5.90,95%CI(3.47,10.02),P<0.00001]均高于单独放疗或同步放化疗组。在不良反应方面,rAd-p53联合放疗或同步放化疗组除发热的发生率高于单独放疗或同步放化疗组[OR=39.78,95%CI(17.96,88.11),P<0.00001]外,其余不良反应发生率两组间均无统计学差异。结论:重组人p53腺病毒注射液联合放疗或同步放化疗治疗宫颈癌的疗效优于单独放疗或同步放化疗,发热均为自限性,安全性好,因此重组人p53腺病毒注射液作为宫颈癌的有效治疗手段有很大的潜力。Objective:To explore the efficacy and safety of recombinant human adenovirus-p53(rAd-p53)combined with radiotherapy(RT)and chemoradiotherapy(CRT)in treating cervical cancer by Meta-analysis.Methods:The randomized clinical controlled studies of rAd-p53 combined with RT or CRT in the treatment of cervical cancer were collected,which were retrieved from CNKI,Wanfang,CBM,VIP,PubMed,EMBase,The Cochrance of Library,Web of Science,for the deadline of February 2021.Meta-analysis was performed by RevMan 5.3 software after date extraction and quality evaluation.Results:Totally 10 literatures were collected,including 487 patients.The Meta-analysis results showed the complete response(CR)rate[OR=2.45,95%CI(1.63,3.68),P<0.0001]and objective response rate(ORR)[OR=5.90,95%CI(3.47,10.02),P<0.00001]in the rAd-p53+RT/CRT group were significantly improved compared with the RT/CRT group.In incidence of adverse reactions,only the occurrence rate of fever[OR=39.78,95%CI(17.96,88.11),P<0.00001]in rAd-p53+RT/CRT group was higher than the RT/CRT group,and there was no significant difference in other adverse reactions.Conclusion:rAd-p53 combined with RT/CRT for the treatment of cervical cancer is superior to the RT/CRT group.Meanwhile,fever is self-limited,and the safety is identified.Therefore,rAd-p53 has great potential as an effective therapy for cervical cancer.

关 键 词：宫颈癌 放疗 放化疗 重组人P53腺病毒注射液 META分析 

分 类 号：R737.33[医药卫生—肿瘤]