肿瘤
腫瘤
종류
TUMOR
2010年
3期
232-238
,共7页
倪田根%关泉林%王娜%高晨%周欣%杨含腾
倪田根%關泉林%王娜%高晨%週訢%楊含騰
예전근%관천림%왕나%고신%주흔%양함등
结直肠肿瘤%肿瘤转移%贝伐单抗%系统评价
結直腸腫瘤%腫瘤轉移%貝伐單抗%繫統評價
결직장종류%종류전이%패벌단항%계통평개
Colorectal neoplasms%Neoplasm metastasis%Bevacizumab%Systematic review
目的:系统评价贝伐单抗(bevacizumab, BEV)联合化疗一线治疗转移性结直肠癌的有效性和安全性.方法:利用计算机检索PubMed、Embase、Cochrane图书馆、中国期刊全文数据库、中国生物医学文献数据库和中文科技期刊全文数据库中的BEV联合化疗一线治疗转移性结直肠癌的随机对照试验,对纳入研究的方法学质量进行评价,并进行荟萃分析.结果:共纳入6篇文献,包括2 646名患者.荟萃分析结果显示,BEV联合化疗组的有效率(完全缓解+部分缓解)较高(相对危险度为1.27,95%的可信区间为1.00~1.61,P= 0.05),且中位生存时间和无进展生存(progression-free survival, PFS)时间延长.治疗组与对照组总的3/4级不良反应、3/4级高血压、不良反应所致研究中止以及胃肠穿孔发生率的差异均有统计学意义,其相对危险度(95%的可信区间)分别为1.12(1.07~1.61)、4.51(2.81~7.23)、1.37(1.16~1.63)和4.32(1.24~15.05);而3/4级出血、60 d全因死亡率、3/4级蛋白尿、3/4级腹泻、3/4级白细胞减少和肺栓塞的发生率差异则无统计学意义,其相对危险度(95%的可信区间)分别为1.50(0.87~2.57)、0.71(0.45~1.11)、2.26(0.69~7.33)、1.18(0.99~1.41)、1.17(0.97~1.42)和0.84(0.46~1.53). 结论:BEV联合化疗一线治疗转移性结直肠癌可提高有效率,延长PFS和中位生存时间,但总的3/4级不良反应、3/4级高血压和胃肠穿孔的发生率较高.
目的:繫統評價貝伐單抗(bevacizumab, BEV)聯閤化療一線治療轉移性結直腸癌的有效性和安全性.方法:利用計算機檢索PubMed、Embase、Cochrane圖書館、中國期刊全文數據庫、中國生物醫學文獻數據庫和中文科技期刊全文數據庫中的BEV聯閤化療一線治療轉移性結直腸癌的隨機對照試驗,對納入研究的方法學質量進行評價,併進行薈萃分析.結果:共納入6篇文獻,包括2 646名患者.薈萃分析結果顯示,BEV聯閤化療組的有效率(完全緩解+部分緩解)較高(相對危險度為1.27,95%的可信區間為1.00~1.61,P= 0.05),且中位生存時間和無進展生存(progression-free survival, PFS)時間延長.治療組與對照組總的3/4級不良反應、3/4級高血壓、不良反應所緻研究中止以及胃腸穿孔髮生率的差異均有統計學意義,其相對危險度(95%的可信區間)分彆為1.12(1.07~1.61)、4.51(2.81~7.23)、1.37(1.16~1.63)和4.32(1.24~15.05);而3/4級齣血、60 d全因死亡率、3/4級蛋白尿、3/4級腹瀉、3/4級白細胞減少和肺栓塞的髮生率差異則無統計學意義,其相對危險度(95%的可信區間)分彆為1.50(0.87~2.57)、0.71(0.45~1.11)、2.26(0.69~7.33)、1.18(0.99~1.41)、1.17(0.97~1.42)和0.84(0.46~1.53). 結論:BEV聯閤化療一線治療轉移性結直腸癌可提高有效率,延長PFS和中位生存時間,但總的3/4級不良反應、3/4級高血壓和胃腸穿孔的髮生率較高.
목적:계통평개패벌단항(bevacizumab, BEV)연합화료일선치료전이성결직장암적유효성화안전성.방법:이용계산궤검색PubMed、Embase、Cochrane도서관、중국기간전문수거고、중국생물의학문헌수거고화중문과기기간전문수거고중적BEV연합화료일선치료전이성결직장암적수궤대조시험,대납입연구적방법학질량진행평개,병진행회췌분석.결과:공납입6편문헌,포괄2 646명환자.회췌분석결과현시,BEV연합화료조적유효솔(완전완해+부분완해)교고(상대위험도위1.27,95%적가신구간위1.00~1.61,P= 0.05),차중위생존시간화무진전생존(progression-free survival, PFS)시간연장.치료조여대조조총적3/4급불량반응、3/4급고혈압、불량반응소치연구중지이급위장천공발생솔적차이균유통계학의의,기상대위험도(95%적가신구간)분별위1.12(1.07~1.61)、4.51(2.81~7.23)、1.37(1.16~1.63)화4.32(1.24~15.05);이3/4급출혈、60 d전인사망솔、3/4급단백뇨、3/4급복사、3/4급백세포감소화폐전새적발생솔차이칙무통계학의의,기상대위험도(95%적가신구간)분별위1.50(0.87~2.57)、0.71(0.45~1.11)、2.26(0.69~7.33)、1.18(0.99~1.41)、1.17(0.97~1.42)화0.84(0.46~1.53). 결론:BEV연합화료일선치료전이성결직장암가제고유효솔,연장PFS화중위생존시간,단총적3/4급불량반응、3/4급고혈압화위장천공적발생솔교고.
Objective:To systematically assess the efficacy and safety of bevacizumab (BEV) plus chemotherapeutic agents as first-line therapy for metastatic colorectal cancer (mCRC). Methods:We retrieved randomized controlled clinical trials (RCTs) of BEV plus chemotherapeutic agents as first-line therapy for mCRC from the databases of PubMed (1966 to August 2009), Embase (1974 to August 2009), Cochrane Library (Issue 3, 2009), China Journal Full Text Database (CJFD, 1994 to August 2009), Chinese Bio-medical Literature Database(CBM, 1978 to August 2009) and Chinese Scientific Journals Full Text Database (CSJD, 1989 to August 2009). Then we evaluated the methodological quality of included studies. Meta-analysis was performed using RevMan 5.0 software developed by the Cochrane Collaboration. Results:Only 6 clinical studies were selected and 2 646 eligible patients were included in the systematic review. Meta-analysis showed that BEV plus chemotherapy increased the overall response rate (complete response+partial response) compared with chemotherapy alone. The relative risk was 1.27 (95%CI: 1.00-1.61, P=0.05), and the median survival time and progression-free survival (PFS) were longer. In terms of safety, there was a significant difference in the frequency of grade 3/4 adverse events, grade 3/4 hypertension, adverse events-induced study discontinuation and gastrointestinal perforation between the two groups. The relative risk was 1.12 (95%CI: 1.07-1.61), 4.51 (95%CI: 2.81-7.23), 1.37 (95%CI: 1.16-1.63)and 4.32(95% CI:1.24-15.05), respectively. There was no statistical difference between the two groups in the incidence of grade 3/4 bleeding, 60-day all-cause mortality, grade 3/4 proteinuria, grade 3/4 diarrhea, grade 3/4 leukopenia and pulmonary embolism. The relative risk was 1.50(95%CI: 0.87-2.57), 0.71(95%CI: 0.45-1.11), 2.26(95%CI: 0.69-7.33), 1.18(95%CI: 0.99-1.41), 1.17 (95%CI: 0.97-1.42)and 0.84(95%CI: 0.46-1.53), respectively. Conclusion:BEV plus chemotherapeutic agents as first-line the-rapy increases the response rate and prolongs PFS and median survival time of mCRC patients, but results in a higher incidence of any grade 3/4 adverse event, grade 3/4 hypertension and gastrointestinal perforation.