氨磷汀减轻非小细胞肺癌同期化放疗中放射性食管炎和肺炎的Meta分析

Amifostine Reduces Acute Esophagitis and Pneumonitis in Local Advanced Non-Small-Cell Lung Cancer Patients Receiving Concurrent Chemotherapy and Radiation:Results of A Meta-Analysis

目的应用Meta分析的方法探讨氨磷汀减轻非小细胞肺癌同期化放疗中放射性食管炎和放射性肺炎的价值。材料和方法在MEDLINE、Cochrane图书馆、美国临床肿瘤学会、欧洲肿瘤协会的官方网站及中国生物医学文献数据库检索有关非小细胞肺癌同期化放疗期间用与不用氨磷汀的前瞻性随机对照研究。对发生严重放射性食管炎和放射性肺炎的相对危险度进行Meta分析。结果分别有5项和3项研究,各520和372例患者纳入分析,氨磷汀能使非小细胞肺癌同期化放疗期间发生严重放射性食管炎的相对危险度减少33%(P=0.003),而入组人数最多(242例)的研究中,氨磷汀并不能降低发生严重放射性食管炎的风险。另外Meta分析表明氨磷汀不能降低发生严重放射性肺炎的风险(P=0.42)。结论氨磷汀有可能降低非小细胞肺癌患者同期化放疗期间严重的放射性食管炎的发生率,但不能降低严重的放射性肺炎的发生,氨磷汀的给药方案需要进一步探讨。

Objective To evaluate the efficacy of Amifostine in diminishing concurrent chemotherapy and radiotherapy side effects of acute serious esophagitis and pneumonitis. Methods and Materials Search all of RCT comparing the use of Amffostine vs. no Amifostine in local advanced non-small-cell lung cancer patients receiving concurrent chemotherapy and radiation in MEDLINE, Cochrane Library, official net of ASCO,ESMO and CBM database. Results This systematic review included 5 and 3 randomized controlled trials, comprising 520 and 372 patients respectively. The use of Amffostine significantly reduced the risk of developing serious esophagitis （relative risk 0.67%, P=-0.003）, which was opposite the large trial. But it couldn＇t reduce the risk of developing acute serious pneumonitis （P=0.42）. Conclusions This systematic review shows that Amifostine significantly reduced the risk of developing ser/ous esophagitis in local advanced non-small-cell lung cancer patients receiving concurrent chemotherapy and radiation. But it couldn＇t reduce the risk of developing serious pneumonitis. The best regiment of Amifostine should study more.