Kim Woo Il, Kim Sooyoung, Cho Sung Woo, Cho Moon Kyun
Department of Dermatology, Soonchunhyang University Hospital, Seoul, Korea.
Department of Surgery, Soonchunhyang University Hospital, Seoul, Korea.
J Cosmet Dermatol. 2020 Dec;19(12):3357-3366. doi: 10.1111/jocd.13390. Epub 2020 Apr 3.
Pathologic scars can lead to itching, erythema, and psychological stress due to cosmetic problems. Bleomycin, one of anticancer agents, has been used for treating keloid or hypertrophic scar. Some studies have shown that bleomycin can induce markedly scar improvement.
To evaluate the efficacy of bleomycin compared to corticosteroid as well as other treatments for keloid or hypertrophic scar using meta-analysis methods.
A computerized search was performed in different databases including Cochrane, Embase, and PubMed. Three randomized controlled trials (RCTs) and two controlled clinical trials (CCTs) were included. Then, statistical analyses of extracted outcome data from the studies were calculated using Rex (version 3.0.1; RexSoft Inc).
Scar improvement was significantly increased in the bleomycin group compared to the triamcinolone acetonide (TAC) group (SMD: 0.59, 95% CI: 0.30-0.88, P < .0001). In addition, there was also statistically significant difference between the bleomycin group and the 5-FU group (SMD: 1.37, 95% CI: 0.88-1.85, P < .0001). Bleomycin increased relatively scar improvement compared to TAC combined with 5-FU, although there was no statistical difference (SMD: 0.63, 95% CI: -0.59-1.84, P = .3108). Furthermore, bleomycin demonstrated significantly increased improvement of scar compared to TAC combined with cryotherapy (SMD: 1.11, 95% CI: 0.48-1.74, P = .0006).
This meta-analysis found that bleomycin was more effective for treating keloid or hypertrophic scar than other treatments including TAC, 5-FU, TAC combined with 5-FU, and TAC combined with cryotherapy. However, further comprehensive studies, including randomized controlled trials, are needed to perform objective analysis.
病理性瘢痕可因美容问题导致瘙痒、红斑和心理压力。博来霉素作为一种抗癌药物，已被用于治疗瘢痕疙瘩或增生性瘢痕。一些研究表明，博来霉素可显著改善瘢痕。
采用荟萃分析方法评估博来霉素与皮质类固醇以及其他治疗方法相比，对瘢痕疙瘩或增生性瘢痕的疗效。
在不同数据库（包括Cochrane、Embase和PubMed）中进行计算机检索。纳入三项随机对照试验（RCT）和两项对照临床试验（CCT）。然后，使用Rex（3.0.1版；RexSoft公司）对研究中提取的结局数据进行统计分析。
与曲安奈德（TAC）组相比，博来霉素组的瘢痕改善情况显著增加（标准化均数差：0.59，95%置信区间：0.30 - 0.88，P <.0001）。此外，博来霉素组与5-氟尿嘧啶（5-FU）组之间也存在统计学显著差异（标准化均数差：1.37，95%置信区间：0.88 - 1.85，P <.0001）。与TAC联合5-FU相比，博来霉素相对增加了瘢痕改善，尽管无统计学差异（标准化均数差：0.63，95%置信区间：-0.59 - 1.84，P = 0.3108）。此外，与TAC联合冷冻疗法相比，博来霉素显示瘢痕改善显著增加（标准化均数差：1.11，95%置信区间：0.48 - 1.74，P = 0.0006）。
这项荟萃分析发现，与包括TAC、5-FU、TAC联合5-FU以及TAC联合冷冻疗法在内的其他治疗方法相比，博来霉素治疗瘢痕疙瘩或增生性瘢痕更有效。然而，需要进一步进行包括随机对照试验在内的全面研究以进行客观分析。
