Jordan Berit, Jahn Franziska, Beckmann Juliane, Unverzagt Susanne, Müller-Tidow Carsten, Jordan Karin
Department of Neurology, Martin Luther University Halle-Wittenberg, Halle/Saale, Germany.
Oncology. 2016;90(6):299-306. doi: 10.1159/000445977. Epub 2016 May 12.
The objective of this systematic review was to summarize the evidence of calcium and magnesium (CaMg) infusions in the prevention of oxaliplatin-induced neuropathy on the basis of prospective randomized controlled trials (RCTs).
A systematic search included MEDLINE and CENTRAL, plus major oncology conferences, and identified RCTs evaluating CaMg. Efficacy endpoints were chronic neurotoxicity measured with National Cancer Institute Common Terminology Criteria for Adverse Events grades and the oxaliplatin-specific scale (OSS). Data were synthesized using a random effects model.
A total of 5 trials with 694 evaluable patients were included in this analysis. The pooled result stated the outcome of the largest study included [Loprinzi et al.: J Clin Oncol 2014;32:997-1005], in which no differences were detected for the incidence of grade ≥2 neuropathy between those receiving CaMg infusions and controls [relative risk (RR) 0.81, 95% confidence interval (CI) 0.60-1.11]. Only 2 studies (n = 52) quoted an incidence of chronic neurotoxicity for all grades (with a pooled RR of 0.95 and 95% CI 0.69-1.32), with substantial statistical heterogeneity. Three studies reported an actual incidence of the OSS but, due to the detected substantial statistical heterogeneity, the studies were not pooled.
The results of our systematic review demonstrated the nonbeneficial effect of CaMg infusions for the prevention of oxaliplatin-induced peripheral neuropathy.
本系统评价的目的是基于前瞻性随机对照试验（RCT）总结钙镁（CaMg）输注预防奥沙利铂所致神经病变的证据。
系统检索包括MEDLINE和CENTRAL以及主要的肿瘤学会议，并识别评估CaMg的RCT。疗效终点为使用美国国立癌症研究所不良事件通用术语标准分级和奥沙利铂特异性量表（OSS）测量的慢性神经毒性。数据采用随机效应模型进行综合分析。
本分析共纳入5项试验，694例可评估患者。汇总结果表明纳入的最大规模研究[洛普林齐等人：《临床肿瘤学杂志》2014年；32：997 - 1005]的结果，其中接受CaMg输注者与对照组之间≥2级神经病变的发生率未检测到差异[相对危险度（RR）0.81，95%置信区间（CI）0.60 - 1.11]。仅2项研究（n = 52）报告了所有级别的慢性神经毒性发生率（汇总RR为0.95，95% CI 0.69 - 1.32），存在显著的统计学异质性。3项研究报告了OSS的实际发生率，但由于检测到显著的统计学异质性，未对这些研究进行汇总。
我们系统评价的结果表明CaMg输注对预防奥沙利铂所致周围神经病变无益处。
