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紫杉醇脂质体与紫杉醇联合铂类在不可切除宫颈癌同步放化疗中的疗效与安全性比较:一项Meta分析

[Efficacy and safety of paclitaxel liposomes compared to paclitaxel combined with platinum in concurrent chemoradiotherapy for unresectable cervical carcinoma: a Meta-analysis].

作者信息

Ma X H, Guo K, Dong W L, Jiang J

机构信息

Department of Gynecology and Obstetrics, Qilu Hospital of Shandong University, Jinan 250063, China.

Department of Data Science and Big Data Statistics, School of Statistics, Renmin University of China, Beijing 100872, China.

出版信息

Zhonghua Zhong Liu Za Zhi. 2021 Oct 23;43(10):1132-1139. doi: 10.3760/cma.j.cn112152-20210422-00337.

Abstract

To explore the efficacy and safety of paclitaxel liposomes compared to paclitaxel with platinum in concurrent chemoradiotherapy for unresectable cervical carcinoma. SinoMed, CNKI, WanFang MED ONLINE, VIP, PubMed, MEDLINE, Cochrane Library, Embase and ClinicalTrials.gov were searched to collect the papers or clinical studies of paclitaxel liposomes and paclitaxel combined with platinum in concurrent chemoradiotherapy for unresectable cervical carcinoma from the inception to January 15th 2021 in Chinese and English. Two independent reviewers screened the literatures, extracted the data and assessed the bias of the included studies. Meta-analysis was performed using RevMan 5.4 and R software. Totally 9 papers involving 666 patients with unresectable cervical carcinoma were included. The results of meta-analysis indicated that compared to paclitaxel combined with platinum in concurrent chemoradiotherapy for unresectable cervical carcinoma, paclitaxel liposomes combined with platinum exhibited superiority in near-term efficacy (complete response + partial response) [81.4%(272/334) vs 68.7%(228/332), =1.19; 95% 1.09, 1.29, =0.000 1]; substantially decreased the incidence rates of blood system disorders [myelosuppressio, 50.3%(168/334)vs 65.1%(216/332)], gastrointestinal disorders [34.4%(115/334) vs 55.1%(183/332)], alopecia [42.2%(94/223)vs 63.3%(140/221)], allergic reaction [11.6% (23/198)vs 27.6%(54/196), ≤0.000 1], peripheral neuritis [43.0%(52/121) vs 54.9%(67/122)], or joint and muscle pain [20.3%(16/79) vs 34.6%(28/81), <0.050 0]. Compared to paclitaxel combined with platinum in concurrent chemoradiotherapy for unresectable cervical carcinoma, paclitaxel liposomes is superior in near-term efficacy, and exhibits better safety.

摘要

探讨紫杉醇脂质体与紫杉醇联合铂类同步放化疗治疗不可切除宫颈癌的疗效及安全性。检索中国生物医学文献数据库、中国知网、万方医学网、维普资讯、PubMed、MEDLINE、Cochrane图书馆、Embase及ClinicalTrials.gov,收集关于紫杉醇脂质体及紫杉醇联合铂类同步放化疗治疗不可切除宫颈癌的文献或临床研究,检索时间范围为建库至2021年1月15日,检索语言为中文和英文。由两名独立评价员筛选文献、提取数据并评估纳入研究的偏倚风险。采用RevMan 5.4和R软件进行Meta分析。共纳入9篇文献,涉及666例不可切除宫颈癌患者。Meta分析结果显示,与紫杉醇联合铂类同步放化疗治疗不可切除宫颈癌相比,紫杉醇脂质体联合铂类在近期疗效(完全缓解+部分缓解)方面具有优势[81.4%(272/334) vs 68.7%(228/332),Z=1.19;95%CI 1.09,1.29,P=0.000 1];显著降低血液系统疾病[骨髓抑制,50.3%(168/334) vs 65.1%(216/332)]、胃肠道疾病[34.4%(115/334) vs 55.1%(183/332)]、脱发[42.2%(94/223) vs 63.3%(140/221)]、过敏反应[11.6%(23/198) vs 27.6%(54/196),P≤0.000 1]、周围神经炎[43.0%(52/121) vs 54.9%(67/122)]或关节肌肉疼痛[20.3%(16/79) vs 34.6%(28/81),P<0.050 0]的发生率。与紫杉醇联合铂类同步放化疗治疗不可切除宫颈癌相比,紫杉醇脂质体近期疗效更佳,安全性更好。

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