奥沙利铂所致周围神经病变的预防：一项系统评价与Meta分析

Prevention of Oxaliplatin-Induced Peripheral Neuropathy: A Systematic Review and Meta-Analysis.

作者信息

Peng Siyu, Ying Ariel Fangting, Chan Nicholas Jian Hao, Sundar Raghav, Soon Yu Yang, Bandla Aishwarya

机构信息

Department of Medicine, National University Health System, Singapore, Singapore.

Health Services and System Research, Duke-National University of Singapore (NUS) Medical School, Singapore, Singapore.

出版信息

Front Oncol. 2022 Feb 3;12:731223. doi: 10.3389/fonc.2022.731223. eCollection 2022.

BACKGROUND

Oxaliplatin-induced peripheral neuropathy (OIPN) has significant clinical impact on the quality of life for cancer patients and is a dose limiting toxicity. Trials studying preventive measures have been inconclusive. A systematic review and meta-analysis were conducted to evaluate the existing pharmacological and non-pharmacological interventions to prevent chronic OIPN.

METHODS

Literature databases PubMed-MEDLINE, Embase and Scopus, were searched from 1 Jan 2005 to 08 Aug 2020 and major conferences' abstracts were reviewed for randomized controlled trials that examined the efficacy of any preventive measure for OIPN. The primary outcome measure was the incidence of chronic OIPN with a preventive intervention as compared to placebo or no intervention. The pooled risk ratio and its 95% confidence interval were calculated using a random effects model. A network meta-analysis was conducted to derive indirect evidence of any preventive effect of an intervention against placebo when original trials compared one intervention against another.

RESULTS

Forty-four trials were analyzed describing 29 chemoprotective interventions, including combinations, and 1 non-pharmacological intervention. Ratings were assessed a combination of outcomes with quality assessment using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) framework. Of the 30 interventions examined, there were six interventions supporting potential efficacy, 11 interventions with insufficient evidence and 13 interventions not recommended.

CONCLUSION

Currently, there is insufficient certainty to support any intervention as effective in preventing OIPN. Of note is that most of these studies have focused on pharmacological interventions; non-pharmacological interventions are underexplored. Further research on ways to limit OIPN is needed.

SYSTEMATIC REVIEW REGISTRATION

https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=225095, Prospero Registration Number: CRD42021225095.

背景

奥沙利铂引起的周围神经病变（OIPN）对癌症患者的生活质量有重大临床影响，且是一种剂量限制性毒性。研究预防措施的试验结果尚无定论。进行了一项系统评价和荟萃分析，以评估现有的预防慢性OIPN的药物和非药物干预措施。

方法

检索了2005年1月1日至2020年8月8日的文献数据库PubMed-MEDLINE、Embase和Scopus，并查阅了主要会议的摘要，以寻找检验任何OIPN预防措施疗效的随机对照试验。主要结局指标是与安慰剂或无干预相比，采取预防干预措施时慢性OIPN的发生率。使用随机效应模型计算合并风险比及其95%置信区间。当原始试验将一种干预措施与另一种干预措施进行比较时，进行网络荟萃分析以得出一种干预措施相对于安慰剂的任何预防效果的间接证据。