CAJ | 학술논문

目的：系统评价在转移性结直肠癌（ mCRC）中加入贝伐单抗进行维持治疗对比持续治疗的疗效和安全性，以期为临床制定化疗策略提供依据。方法计算机检索PubMed、EMBASE，检索时限截止到2014年10月，查找应用贝伐单抗作为维持治疗的的随机对照临床试验，按照纳入排除标准进行文献筛选、数据提取和质量评价后，采用Stata 11.2SE软件进行系统评价。结果共纳入4个研究，合计1084例患者。Meta分析结果显示：在疗效方面，含有贝伐单抗的维持治疗方案与持续治疗相比，两者的无进展生存期（ HR=1.06，95%CI：0.65~1.71）和总生存期（ HR=1.08，95% CI：0.93~1.26）相当，但维持治疗组的副作用明显低于持续治疗组（OR=1.51，95%CI：1.22~1.85），维持治疗组的神经系统疾病（OR=3.70，95%CI：2.33~5.88）和手足综合征（OR=1.90，95%CI：1.05~3.44）发生率明显比持续治疗组低。结论在疗效和安全性上，与含有贝伐单抗的持续治疗方案相比，维持治疗方案可以明显改善患者 PFS时间降低副作用。
목적：계통평개재전이성결직장암（ mCRC）중가입패벌단항진행유지치료대비지속치료적료효화안전성，이기위림상제정화료책략제공의거。방법계산궤검색PubMed、EMBASE，검색시한절지도2014년10월，사조응용패벌단항작위유지치료적적수궤대조림상시험，안조납입배제표준진행문헌사선、수거제취화질량평개후，채용Stata 11.2SE연건진행계통평개。결과공납입4개연구，합계1084례환자。Meta분석결과현시：재료효방면，함유패벌단항적유지치료방안여지속치료상비，량자적무진전생존기（ HR=1.06，95%CI：0.65~1.71）화총생존기（ HR=1.08，95% CI：0.93~1.26）상당，단유지치료조적부작용명현저우지속치료조（OR=1.51，95%CI：1.22~1.85），유지치료조적신경계통질병（OR=3.70，95%CI：2.33~5.88）화수족종합정（OR=1.90，95%CI：1.05~3.44）발생솔명현비지속치료조저。결론재료효화안전성상，여함유패벌단항적지속치료방안상비，유지치료방안가이명현개선환자 PFS시간강저부작용。
Objective This meta-analysis compared the efficacy and safety of maintenance strategies added bevacizumab with continuous strategies added bevacizumab in metastatic colorectal cancer( mCRC). Methods Potentially relevant studies,which has maintenance strategies with bevacizumab from inception to October 2014,were identified through a structured literature search using the PubMed,EMBASE,and Co-chrane databases independently. The statistical analysis was performed according to Stata version 11. 2SE(Stata Corp). Results 4 studies were included in the meta-analysis. For PFS or OS of maintenance strategies with bevacizumab versus continuous strategies with bevacizumab( HR=1. 06,95%CI:0. 65-1. 71;HR=1. 08,95%CI:0. 93-1. 26;respectively). All models suggested similar outcome within the range of non-inferiority. Grade 3/4 toxicities(neuropathy-OR=3. 70,95%CI:2. 33-5. 88;hand-foot syndrome -OR=1. 90,95%CI:1. 05-3. 44) were less prominent with maintenance strategies compared to continuous strategies. Conclusion Considerring the efficacy and safety,the mainte-nance therapies with bevacizumab can significantly improve PFS and reduce grade 3/4 toxicities.