基于数据挖掘骨肉瘤化疗方案的推荐与选择  

Recommendation and selection of chemotherapy regimen for osteosarcoma:a data mining-based analysis

作　　者：陈倩[1] 郑凯[2] 徐明[2] 于秀淳 CHEN Qian;ZHENG Kai;XU Ming;YU Xiu-chun(Shandong University of Traditional Chinese Medicine.Jinan,Shandong,250355,China)

机构地区：[1]山东中医药大学,济南250355 [2]中国人民解放军第九六〇医院骨科,济南250031

出　　处：《中国骨与关节杂志》2023年第5期323-330,共8页Chinese Journal of Bone and Joint

摘　　要：目的 归纳总结骨肉瘤化疗方案特点,选择优化方案以期指导临床实践。方法 以“骨肉瘤、化疗”英文单词和近义词为检索词,在PubMed、Embase英文文献数据库中进行检索,依据纳入排除标准,建立骨肉瘤化疗方案及药物应用的数据库,对数据进行关联规则分析及聚类分析。结果 共纳入30篇文献,涉及化疗方案10种、化疗药物9种;高频使用的药物包括甲氨蝶呤(MTX) 4423次、顺铂(DDP)6046次、多柔比星(ADM) 5878次和异环磷酰胺(IFO) 2808次;高频使用的方案包括MAPI方案2000次、MAP方案2336次、AP方案831次和DIA方案635次。术前采用MAPI方案的患者肿瘤组织学坏死率≥90%(632/990);术后化疗并发症、肺转移及局部复发发生率,MAP方案组要优于MAPI方案组及DIA方案组。骨转移发生率(MAPI方案1.2%,MAP方案1.8%,DIA方案0.7%) 3种方案无统计学意义(χ^(2)=1.170,P=0.557)。结论 MTX、DDP、ADM和IFO仍然是骨肉瘤化疗方案中出现频次最多的药物,基于以上药物的多种方案疗效近似,MAP方案相关并发症略低。Objective To summarize the characteristics of chemotherapy regimen for osteosarcoma and select the optimal regimen in order to guide clinical practice.Methods English words and synonyms of“osteosarcoma”and“chemotherapy”were used as retrieval words,and were retrieved in PubMed and Embase English literature databases.Based on the inclusion and exclusion criteria,a database of chemotherapy regimen and drug application for osteosarcoma was established.Association rule analysis and cluster analysis were conducted.Results A total of 30 literatures were included,involving 10 kinds of chemotherapy schemes and 9 kinds of chemotherapy drugs.Frequently used drugs included methotrexate(MTX,4423 times),cisplatin(DDP,6046 times),doxorubicin(ADM,5878 times)and IFO(2808 times);frequently used schemes included MAPI(2000 times),MAP(2336 times),AP(831 times)and DIA(635 times).The tumor histological necrosis rate was≥90%(632/990)in patients with MAPI regimen before surgery.The incidences of postoperative chemotherapy complication,lung metastasis and local recurrence were higher in MAP group than in MAPI group and DIA group.The differences in bone metastasis incidence(MAPI 1.2%,MAP 1.8%,DIA 0.7%)were not statistically significant(χ^(2)=1.170,P=0.557).Conclusions MTX,DDP,ADM and IFO are still the most frequently used drugs in the chemotherapy regimen for osteosarcoma.Based on these drugs,the efficacy of multiple regimens is similar,and the complication rate associated with MAP regimen is slightly lower.

关 键 词：骨肉瘤 数据挖掘 抗肿瘤联合化疗方案 

分 类 号：R738.1[医药卫生—肿瘤]