白蛋白结合型紫杉醇与其他剂型紫杉醇在卵巢癌中疗效及安全性的Meta分析  

Comparative Efficacy and Safety of Albumin-bound Paclitaxel Versus Other Formulations of Paclitaxel in Ovarian Cancer:A Meta-analysis

作　　者：陈燕贤 陈史钰 李景贺 何秋山 CHEN Yanxian;CHEN Shiyu;LI Jinghe;HE Qiushan(The People’s Hospital of Longhua,Shenzhen 518109,China;Fuwai Hospital Chinese Academy of Medical Sciences,Shenzhen 518038,China)

机构地区：[1]深圳市龙华区人民医院,深圳518109 [2]中国医学科学院阜外医院深圳医院,深圳518038

出　　处：《宁夏医科大学学报》2025年第2期172-180,共9页Journal of Ningxia Medical University

基　　金：深圳市龙华区医疗卫生机构区级科研项目(2021048)。

摘　　要：目的探讨白蛋白结合型紫杉醇与其他剂型紫杉醇在卵巢癌患者中的疗效与安全性差异。方法检索PubMed、Cochrane Library、EMBASE、Web of Science、CNKI、Wanfang Data、VIP中关于白蛋白结合型紫杉醇与其他剂型紫杉醇治疗卵巢癌的临床研究。检索时间从建库至2022年6月18日。筛选文献后提取相关数据,并应用改良Jadad量表和Minors量表分别对随机试验和非随机对照试验进行质量评价。采用Review Manager 5.4软件对纳入文献的数据进行Meta分析。结果共纳入23篇临床研究(样本量1887例),均为中国人群。对所有卵巢癌患者进行分析,白蛋白结合型紫杉醇组的疾病缓解率[OR=2.18,95%CI(1.79,2.65),P<0.001]、疾病控制率[OR=2.55,95%CI(1.95,3.34),P<0.001]、1年生存率[OR=2.45,95%CI(1.68,3.56),P<0.001]、2年生存率[OR=2.43,95%CI(1.52,3.88),P=0.0002]均优于其他剂型紫杉醇组。安全性方面,在卵巢癌患者中,白蛋白结合型紫杉醇组的白细胞减少、恶心呕吐、腹泻发生率低于其他剂型紫杉醇组(P均<0.05);而神经毒性、血小板减少、过敏反应、血红蛋白减少发生率与对照组差异无统计学意义(P均>0.05)。结论在卵巢癌患者中,白蛋白结合型紫杉醇方案优于其他剂型紫杉醇方案,且毒副反应减少、安全可耐受,但仍需大型临床试验进一步验证。Objective To systematically assess the efficacy and safety of the comparison of albumin-bound paclitaxel with other dosage forms of paclitaxel in ovarian cancer patients.Methods PubMed,EMBASE,Web of Science,Cochrane Library,CNKI,Wanfang Data,VIP were searched for clinical studies related to albumin-bound paclitaxel and other paclitaxel in the treatment of patients with ovarian cancer.The retrieval time was from the establishment of the database to June 18,2022.Modified Jadad checklists and methodological index for non-randomized studies were used to assess trials.Review Manager 5.4 software was used for Meta-analysis.Results A total of 23 clinical studies(with a sample size of 1887 cases)were included,all of which were Chinese.When all ovarian cancer patients were analyzed,objective response rate[OR=2.18,95%CI(1.79,2.65),P<0.001],disease control rate[OR=2.55,95%CI(1.95,3.34),P<0.001],1-year survival rate[OR=2.45,95%CI(1.68,3.56),P<0.001]and 2-year survival rate[OR=2.43,95%CI(1.52,3.88),P=0.0002]in albumin-bound paclitaxel group were better than paclitaxel in other dosage forms group.In terms of security in patients with ovarian cancer,the incidence of leukopenia,nausea and vomiting,and diarrhea in albumin-bound paclitaxel was lower than that in other dosage forms of paclitaxel(P all<0.05).While the incidence of adverse reactions such as neurotoxicity,thrombocytopenia,allergic reactions,and hemoglobin reduction was similar to that of the control group(P all>0.05).Conclusion The evidence shows that in patients with ovarian cancer,the albumin-bound paclitaxel is superior to other formulations of paclitaxel,with reduced toxicity and tolerability.The results still need to be evaluated in more clinical trials.

关 键 词：白蛋白结合型紫杉醇 卵巢癌 META分析 其他剂型紫杉醇 

分 类 号：R737.31[医药卫生—肿瘤]