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斑蝥酸钠维生素B6注射液治疗消化系统肿瘤的疗效与安全性:一项随机对照试验的Meta分析

Efficacy and safety of sodium cantharidinate and vitamin B6 injection for the treatment of digestive system neoplasms: a meta-analysis of randomized controlled trials.

作者信息

Liu Meirong, Xu Chunhong, Sun Yingying

机构信息

Department of Oncology, Liaocheng People's Hospital, Liaocheng Clinical School of Taishan Medical University, Liaocheng 252000, Shandong Province, China.

Department of Gastroenterology, Liaocheng People's Hospital, Liaocheng Clinical School of Taishan Medical University, Liaocheng 252000, Shandong Province, China.

出版信息

Drug Des Devel Ther. 2018 Dec 28;13:183-203. doi: 10.2147/DDDT.S190674. eCollection 2019.

DOI:10.2147/DDDT.S190674
PMID:30643386
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6312696/
Abstract

OBJECTIVE

To systematically evaluate the efficacy and safety of sodium cantharidinate and vitamin B6 (SC/B6) combined with conventional medical treatment (CMT) for the treatment of patients with advanced digestive system neoplasms (DSNs).

METHODS

The Cochrane Library, Embase, PubMed, Web of Science, Chinese Scientific Journal Database (VIP), China National Knowledge Infrastructure, and Wanfang databases were searched for clinical trials using SC/B6 for DSNs. Outcome measures, including therapeutic efficacy, quality of life (QoL), and adverse events, were extracted and systematically evaluated.

RESULTS

Data from 24 trials including 1,825 advanced DSN patients were included. Compared with CMT alone, its combination with SC/B6 significantly improved the patients' overall response rate (OR =2.25, 95% CI =1.83-2.76, <0.00001), disease control rate (OR =2.41, 95% CI =1.85-3.15, <0.00001), and QoL improvement rate (OR =2.75, 95% CI =2.13-3.55, <0.00001). Moreover, adverse events caused by chemotherapy, including leukopenia, nausea and vomiting, gastrointestinal side effects, hepatotoxicity, diarrhea, transaminase disorder, myelosuppression, anorexia, and anemia, were significantly alleviated (<0.05) when SC/B6 was applied to DSN patients. Nephrotoxicity, thrombocytopenia, hand-foot syndrome, and oral mucositis were not significantly alleviated in patients receiving combination therapy (>0.05).

CONCLUSION

The combination of SC/B6 and CMT is more effective in treating DSNs than CMT alone. This combination alleviates the adverse effects associated with chemotherapy and improves the QoL of DSN patients, and its application in the clinic is worth promoting.

摘要

目的

系统评价斑蝥酸钠维生素B6(SC/B6)联合传统医学治疗(CMT)对晚期消化系统肿瘤(DSNs)患者的疗效和安全性。

方法

检索Cochrane图书馆、Embase、PubMed、Web of Science、中国科学期刊数据库(VIP)、中国知网和万方数据库,查找使用SC/B6治疗DSNs的临床试验。提取包括治疗效果、生活质量(QoL)和不良事件等结局指标并进行系统评价。

结果

纳入了24项试验的数据,共1825例晚期DSNs患者。与单纯CMT相比,SC/B6联合CMT显著提高了患者的总缓解率(OR =2.25,95%CI =1.83 - 2.76,<0.00001)、疾病控制率(OR =2.41,95%CI =1.85 - 3.15,<0.00001)和QoL改善率(OR =2.75,95%CI =2.13 - 3.55,<0.00001)。此外,当SC/B6应用于DSNs患者时,化疗引起的不良事件,包括白细胞减少、恶心呕吐、胃肠道副作用、肝毒性、腹泻、转氨酶紊乱、骨髓抑制、厌食和贫血,均得到显著缓解(<0.05)。联合治疗患者的肾毒性、血小板减少、手足综合征和口腔黏膜炎未得到显著缓解(>0.05)。

结论

SC/B6与CMT联合治疗DSNs比单纯CMT更有效。这种联合治疗减轻了与化疗相关的不良反应,提高了DSNs患者的QoL,其在临床上的应用值得推广。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5dd8/6312696/a4d6f4759b79/dddt-13-183Fig6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5dd8/6312696/f49b2eb9a8e6/dddt-13-183Fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5dd8/6312696/72b232e8d9f4/dddt-13-183Fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5dd8/6312696/ae4552cfe304/dddt-13-183Fig3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5dd8/6312696/4829a157486b/dddt-13-183Fig4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5dd8/6312696/92ff900d1ba1/dddt-13-183Fig5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5dd8/6312696/a4d6f4759b79/dddt-13-183Fig6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5dd8/6312696/f49b2eb9a8e6/dddt-13-183Fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5dd8/6312696/72b232e8d9f4/dddt-13-183Fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5dd8/6312696/ae4552cfe304/dddt-13-183Fig3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5dd8/6312696/4829a157486b/dddt-13-183Fig4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5dd8/6312696/92ff900d1ba1/dddt-13-183Fig5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5dd8/6312696/a4d6f4759b79/dddt-13-183Fig6.jpg

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