以多柔比星脂质体和表柔比星为基础的乳腺癌患者治疗效果及副作用的meta分析  

The efficacy and side effects of liposomal doxorubicin-based therapy and epirubicin-based therapy for breast cancer patients:a meta-analysis

作　　者：邓浪 熊大艳 田珈硕 丁金锋 唐四元 刘伟 DENG Lang;XIONG Dayan;TIAN Jiashuo;DING Jinfeng;TANG Siyuan;LIU Wei(Xiangya Nursing School,Central South University,Changsha 410013,China;Nursing School,Ningxia Medical University,Yinchuan 750004,China;Nursing School,Xinjiang Medical University,Urumqi 830054,China)

机构地区：[1]中南大学湘雅护理学院,长沙410013 [2]宁夏医科大学护理学院,银川750004 [3]新疆医科大学护理学院,乌鲁木齐830054

出　　处：《广西医科大学学报》2025年第2期277-288,共12页Journal of Guangxi Medical University

基　　金：新疆医科大学科研创新团队项目资助(No.XYD2024C06)。

摘　　要：目的:探讨以多柔比星脂质体(LD)和表柔比星(E)为基础的乳腺癌患者治疗效果及副作用的meta分析。方法:基于PubMed、Embase、中国知网、万方数据库、Web of Science及Cochrane图书馆等6个数据库,采用回顾性研究和随机对照试验(RCT)比较基于LD和基于E的治疗方案的疗效及副作用。采用Cochrane标准,RevMan 5.3软件对试验的病理完全缓解率、心脏毒性、免疫毒性、血液毒性及神经毒性副作用进行分析,用比值比(OR)及其95%置信区间(95%CI)来呈现研究结果。结果:分析了5项RCT和16项回顾性研究,涉及3597例患者。Meta分析结果显示,基于LD的治疗方案在病理完全缓解率(OR=1.31)、心脏毒性事件发生率(OR=0.40)和血液毒性事件发生率(OR=0.59)等方面均优于基于E的治疗方案(P<0.05),但基于LD治疗的免疫毒性(OR=2.52)和神经毒性较高(OR=0.59)(P<0.05)。结论:基于LD的治疗方案较基于E更适合乳腺癌患者,但对于存在免疫系统和神经系统疾病负担或其他相关禁忌证的患者应谨慎选择。Objective:To conduct a meta-analysis to explore the specific efficacy and side effects of liposomal doxorubicin(LD)and epirubicin(E)-based therapies in breast cancer patients.Methods:We searched 6 databases including PubMed,Embase,CNKI,Wanfang Data,Web of Science,and the Cochrane Library,and adopted retrospective studies and randomized clinical trials(RCTs)to compare the efficacy and side effects during LD and Ebased therapies.Cochrane criteria were followed,and the RevMan 5.3 software was used to analyze the pathological complete response rate,as well as the side effects of the trials such as cardiotoxicity,immunotoxicity,hematotoxicity and neurotoxicity.The odds ratios(OR)and 95%confidence intervals(95%CI)were used to present the results.Results:In total,we analyzed the results from 3,597 patients in 5 RCTs and 16 retrospective studies.The meta-analysis results showed that the LD-based therapy had better performance than the E-based therapy in pathological complete response rate(OR=1.31),incidence of cardiotoxic events(OR=0.40)and incidence of hematotoxic events(OR=0.59)(P<0.05).However,LD-based therapy showed significantly higher immunotoxicity(OR=2.52)and neurotoxicity(OR=0.59)(P<0.05).Conclusion:Compared with E-based therapy,LD-based therapy is generally more suitable for breast cancer patients.However,for patients with a burden of immune system and nervous system diseases or other related contraindications,careful selection should be made.

关 键 词：多柔比星脂质体 表柔比星 乳腺癌 疗效 副作用 META分析 

分 类 号：R737.9[医药卫生—肿瘤]