卡培他滨在治疗转移性乳腺癌中作用的Meta分析

目的: 近年来关于卡培他滨在治疗转移性乳腺癌上的研究结论并不一致,现采用Meta分析的方法评价卡培他滨在治疗转移性乳腺癌中的疗效及不良反应。方法: 计算机检索2014年3月以前Cochrane、Pubmed、EMbase、Medline、中国生物医学文献数据库、中国知网、万方数据库的相关文献,根据严格的纳入和排除标准,筛选出加入卡培他滨的化疗方案对比不加卡培他滨的化疗方案的随机或半随机对照试验,最终将数据通过Revman 5.2 软件合并及分析。质量评价采用 Cochrane Handbook 5.0.1 的评价方法。结果: 总共纳入9个随机临床对照实验及1个半随机对照试验,共1 449例患者进行Meta分析,结果显示,联合卡培他滨的化疗方案对比不加入卡培他滨的方案,可以提高总反应率(RR=1.61; 95%CI:1.29~2.02,P<0.0001)及完全反应率(RR=1.68;95%CI:1.04~2.71, P<0.03),减少肌痛和骨髓抑制的几率,但同时会增加胃肠道反应和手足综合征的发生概率。两组方案在部分反应率和其余不良反应上尚不能认为有差异。结论: 联合卡培他滨的化疗方案在治疗转移性乳腺癌的作用上,可以提高总反应率及完全反应率,但是治疗过程中应注意防治胃肠道反应及手足综合征等不良反应。

Meta analysis on the efficacy of capecitabine in the chemotherapy of metastatic breast cancer

AIM: In recent years, the conclusion about the efficacy and toxicity of capecitabine in the chemotherapy of metastatic breast cancer was discordant. This Meta analysis was to ascertain the efficacy and toxicity of capecitabine in metastatic or advanced breast cancer.METHODS: By searching the Cochrane, Pubmed, EMbase, Medline, CBM, CNKI, Wanfang databases, randomized controlled trials (RCTs) and quasi-RCTs about chemotherapy with or without capecitabine before March 2014 were included. Date were merged and analysed by RevMan 5.2.RESULTS: Nine RCTs and one quasi-RCT involving 1 449 patients with advanced or metastatic breast cancer were included. Results showed that the chemotherapy which included capecitabine had higher overall survival (OR)(RR=1.61;95%CI:1.29-2.02,P<0.0001), complete survival (CR)(RR=1.68;95%CI:1.04-2.71,P<0.03), gastrointestinal reaction, hand-foot syndrome rate and lower myalgia rate, myelotoxicity rate when compared with chemotherapy without capecitabine.CONCLUSION: This Meta analysis shows that chemotherapy which included capecitabine can increase the OR and CR in the metastatic or advance breast cancer. Correspondingly, people should pay more attention to some of the adverse events such as hand-foot syndrome.