摘要
目的:系统评价紫杉醇联合奈达铂对卵巢癌患者进行治疗的安全性和有效性。方法:计算机检索Pub Med、Cochrane Library、Embase、CNKI、Wan Fang Data、Sino Med数据库,搜集有关紫杉醇联合奈达铂治疗卵巢癌的随机对照试验(RCTs)。检索时限均为建库至2018年4月,由两名研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用Rev Man 5. 3软件进行分析。结果:共纳入12项研究,包括1 219例患者。Meta分析结果显示,紫杉醇联合奈达铂治疗卵巢癌的总有效率与其他化疗方案相比,差异无统计学意义[OR=1. 14,95%CI (0. 88,1. 48),P=0. 16],但紫杉醇联合奈达铂可提高患者1年生存率[OR=3. 37,95%CI(1. 47,7. 71),P=0. 004]和2年生存率[OR=2. 24,95%CI(1. 27,3. 97),P=0. 006],并且该方案显著减少了不良反应的发生率:血小板降低[OR=0. 49,95%CI(0. 36,0. 66),P=0. 000 01]、恶心呕吐[OR=0. 65,95%CI(0. 47,0. 89),P=0. 007]、外周神经毒性[OR=0. 43,95%CI(0. 28,0. 67),P=0. 000 2]及肝功能损伤[OR=0. 39,95%CI(0. 20,0. 77),P=0. 006]等不良反应的发生率。结论:紫杉醇联合奈达铂治疗卵巢癌可延长患者1年及2年生存率且不良反应较轻,受研究数量和质量的限制,结论还需更多高质量的RCTs进行验证。
Objective: To systematically evaluate the efficacy and safety of paclitaxel combined with nedaplatin compared with other chemotherapeutics for ovarian cancer. Methods: The databases including Pub Med,Cochrane Library,Embase,CNKI,Wan Fang Data,Sino Med were electronically searched from inception to April 2018 to collect the randomized controlled trials( RCTs) about paclitaxel combining nedaplatin and other chemotherapeutics for ovarian cancer. Two reviewers independently screened literature,extracted data and assessed the risk of bias of included studies. Then Meta-analysis was performed by Rev Man 5. 3 software. Results: A total of 12 studies were included,involving 1 219 patients. The results of Meta-analysis showed that: paclitaxel combining nedaplatin had no significant difference in total effective rate( OR = 1. 14,95% CI 0. 88 to 1. 48,P = 0. 16),but this chemotherapy regimen significantly increased the 1-year survical rate( OR = 3. 37,95% CI 1. 47 to 7. 71,P = 0. 004) and 2-year survical rate( OR = 2. 24,95% CI 1. 27 to 3. 97,P =0. 006) compared with other chemotherapeutics. The occurrence of lower thrombocyte( OR = 0. 49,95% CI 0. 36 to 0. 66,P = 0. 000 01),vomiting adverse reaction( OR = 0. 65,95% CI 0. 47 to 0. 89,P = 0. 007),Peripheral neurotoxicity( OR= 0. 43,95% CI 0. 28 to 0. 67,P = 0. 000 2) and liver function damage( OR = 0. 39,95% CI 0. 20 to 0. 77,P = 0. 006)were also significantly decreased by using paclitaxel combining nedaplatin. Conclusion: Paclitaxel combined with nedaplatin for the treatment of ovarian cancer could reduce the toxic adverse effect while increasing the patient survival rate. The conclusion still need to be verified by more high-quality research due to limited sample size and quality in this study.
引文
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