奥氮平联合5-羟色胺受体拮抗剂治疗铂类相关性恶心呕吐的系统评价

Systematic evaluation of olanzapine combined with 5-HT receptor antagonist in the treatment of platinum-related nausea and vomiting

目的系统评价奥氮平联合5-羟色胺(5-HT)受体拮抗剂治疗铂类相关性恶心呕吐(CINV)的临床疗效。方法计算机检索多个中外文献数据库,收集建库至2018年6月1日发表的奥氮平治疗含铂化疗CINV的随机对照试验相关文献。按照Cochrane手册对纳入的文献进行质量评价,并应用RevMan5.3软件进行Meta分析。结果共纳入8项研究,共1060例患者。Meta分析结果显示,奥氮平能显著提高患者急性CINV的缓解率RR=8.07,95%CI(1.12,1.50),P=0.0004]和迟发性RR=18.39,95%CI(1.24,2.15),P=0.0005],优于对照组,差异均有统计学意义。结论对于常规止吐方案无效的爆发性或难治性CINV可推荐采用包含奥氮平的止吐方案。

Objective To evaluate the effect of olanzapine combined with 5-HT receptor antagonist in the treatment of platinum-related nausea and vomiting. Methods Literature on olanzapine treating platinum-containing chemotherapy CINV in multiple databases up to June 1st, 2018 was collected. The quality of the included literature was evaluated according to the Cochrane Handbook and Meta-analysis was performed using RevMan5.3 software. Results 8 studies were included, covering 1060 patients. Meta-analysis showed that olanzapine significantly improved the remission rate[RR=8.07, 95% CI (1.12, 1.50), P=0.0004], and delayed onset [RR=18.39, 95% CI (1.24, 2.15), P=0.0005] of acute CINV in patients, superior to the control group, and the difference was statistically significant. Conclusion An antiemetic regimen containing olanzapine may be recommended for explosive or refractory CINV in which conventional antiemetic regimens are not effective.