新诊断的 II 期、III 期或 IV 期上皮性卵巢、输卵管或原发性腹膜癌的巩固或维持全身治疗：系统评价。
Consolidation or maintenance systemic therapy for newly diagnosed stage II, III, or IV epithelial ovary, fallopian tube, or primary peritoneal carcinoma: A systematic review.
机构信息
Department of Oncology, Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.
Department of Oncology, Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada; Program in Evidence-Based Care, Ontario Health (Cancer Care Ontario), Toronto, Ontario, Canada.
出版信息
Crit Rev Oncol Hematol. 2021 Jun;162:103336. doi: 10.1016/j.critrevonc.2021.103336. Epub 2021 Apr 16.
BACKGROUNDS
To systematically review the effectiveness and harm of consolidation or maintenance therapy in patients with newly diagnosed stage II-IV EOC.
METHODS
MEDLINE, EMBASE, PubMed, Cochrane Library, and PROSPERO databases, and four relevant conferences were systematically searched. We adhered to PRISMA guidelines, and used the GRADE approach to aggregate data.
RESULTS
Among 12,675 citations, 28 comprising 16,310 patients were analyzed. The certainty of aggregated study evidence ranged from high to low.
CONCLUSIONS
The existing evidence does not find overall survival benefit for consolidation therapy with chemotherapy. For maintenance therapy, comparing with placebo, olaparib, niraparib, veliparib, and bevacizumab are effective as maintenance therapy for certain patients with newly diagnosed stage III-IV epithelial ovarian, fallopian tube, or primary peritoneal carcinoma respectively without reducing quality of life. Longer follow-up with more mature results of overall survival will better define the effect of these agents.
背景
系统评价新诊断的 II-IV 期卵巢上皮癌（EOC）患者巩固或维持治疗的有效性和危害。
方法
系统检索 MEDLINE、EMBASE、PubMed、Cochrane 图书馆和 PROSPERO 数据库以及四个相关会议，遵循 PRISMA 指南，并使用 GRADE 方法汇总数据。
结果
在 12675 条引文，28 项研究包含 16310 例患者被分析。汇总研究证据的确定性从高到低不等。
结论
现有证据并未发现化疗巩固治疗有总体生存获益。对于维持治疗，与安慰剂相比，奥拉帕利、尼拉帕利、维利帕利和贝伐珠单抗分别作为新诊断的 III-IV 期上皮性卵巢癌、输卵管癌或原发性腹膜癌的维持治疗对某些患者有效，而不降低生活质量。更长时间的随访和更成熟的总生存结果将更好地确定这些药物的效果。
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