紫杉醇联合帕唑帕尼治疗铂耐药复发性卵巢癌有效性和安全性的meta分析  

The efficacy and safety of paclitaxel combined with pazopanib for platinum-resistant recurrent ovarian cancer:meta-analysis

作　　者：王皓正 张国华 Wang Haozheng;Zhang Guohua(Nanchang University,Nanchang 330036;Gaoxin Branch of the First Affiliated Hospital of Nanchang University,Nanchang Key Laboratory of Tumor Gene Diagnosis and Innovative Treatment,Nanchang 330096)

机构地区：[1]南昌大学,南昌330036 [2]南昌大学第一附属医院高新医院,南昌市基因诊断与治疗重点实验室,南昌330096

出　　处：《现代妇产科进展》2024年第12期915-921,共7页Progress in Obstetrics and Gynecology

基　　金：国家自然科学基金(No:82160493);江西省自然科学基金(No:20212BAB206081;No:20224ACB206018)。

摘　　要：目的:探讨紫杉醇联合帕唑帕尼治疗铂耐药复发性卵巢癌的有效性和安全性。方法:检索PubMed、Web of Science、Cochrane Library、EMbase、Ovid Medline、ScienceDirect、Scopus、中国知网(CNKI)、万方和维普等数据库,检索时限均为建库至2023年11月24日,纳入紫杉醇联合帕唑帕尼或不联合帕唑帕尼治疗铂耐药复发性卵巢癌的文献。运用Revman5.4软件进行meta分析。结果:最终纳入3篇文献,共295例患者,其中紫杉醇+帕唑帕尼组168例,紫杉醇组127例。Meta分析结果显示,相比紫杉醇组,紫杉醇联合帕唑帕尼组的完全缓解(CR)(RR=1.47,95%CI为0.44~4.94)、无进展生存时间(PFS)(HR=0.68,95%CI为0.40~1.15)、总生存期(OS)(HR=0.87,95%CI为0.63~1.20)表现出有利的倾向。两组的客观缓解率(ORR)、疾病控制率(DCR)、部分缓解(PR)、病情稳定(SD)比较,差异均无统计学意义。与紫杉醇组相比,紫杉醇+帕唑帕尼组的生存优势随着生存时间延长而增加,但安全性较差,发病率前五的不良事件包括贫血、疲劳、中性粒细胞减少、恶心、高血压。结论:对于铂耐药复发性卵巢癌,紫杉醇+帕唑帕尼组相比紫杉醇组在治疗疗效上表现出有利的倾向,但需避免不良事件。Objective:To explore the efficacy and safety of paclitaxel combined with pazopanib versus paclitaxel in the treatment of platinum-resistant recurrent ovarian cancer.Methods:PubMed,Web of Science,Cochrane Library,EMbase,Ovid Medline,ScienceDirect,Scopus,CNKI,Wanfang,and VIP Database were searched and the literature was analyzed from the date of establishment of the library to November 24,2023.The meta-analysis was performed using Revman 5.4 software.Result:Three publications were included,with a total of 295 patients(168 patients in paclitaxel+pazopanib group and 127 patients in paclitaxel group).The meta-analysis results indicated that compared with the paclitaxel group,the paclitaxel combined with pazopanib group showed a favorable trend in terms of complete remission(CR)(RR=1.47,95%CI 0.44~4.94),progression-free survival(PFS)(HR=0.68,95%CI 0.40~1.15),and overall survival(OS)(HR=0.87,95%CI 0.63~1.20),but these differences were not statistically significant.The objective response rate(ORR),disease control rate(DCR),partial response rate(PR)and stable disease condition(SD)were not significantly different between the two groups.In addition,the survival advantage of the paclitaxel+pazopanib group increased with longer survival time compared to the paclitaxel group.However,it performed poorly on safety measures,with the top five adverse events in terms of incidence including anemia,fatigue,neutropenia,nausea and hypertension.Conclusions:For the treatment of platinum-resistant recurrence,the paclitaxel combined with pazopanib program has certain advantages in terms of therapeutic efficacy,but it is necessary to avoid the adverse toxic side effects.

关 键 词：紫杉醇 帕唑帕尼 卵巢癌 META分析 

分 类 号：R713.4[医药卫生—妇产科学]