二磷酸盐治疗前列腺癌骨转移的系统评价

Systematic review of the study on Bisphosphonates for the treatment of advanced prostate cancer

目的探讨二磷酸盐类药物缓解前列腺癌骨转移性疼痛的效果。方法计算机检索Medline(1966年至2007年12月)、Embase(1966年至2007年1月)、Cochrane图书馆(2007年第四期)及中国生物医学数据库(1979年至2007年12月),收集所有相关随机对照试验,并采用Revman4.2进行Meta-分析。结果共纳入10个随机对照试验。Meta-分析表明,与对照组相比,二磷酸盐类药物可以减轻疼痛,减少止痛剂的使用,降低了骨骼事件的发生率,但并不能改善患者的病死率。恶心在二磷酸盐类药物组发生率较高,而其他各种副作用无统计学差异。结论二磷酸盐类药物在减轻前列腺癌骨转移患者的疼痛及骨并发症上有一定作用。除恶心外,其他的副作用没有明显增加。需要进行更多的研究来提高这些结论的证据级别。

Objective To determine the effectiveness of Bisphosphonates on relieving pain in p prostate cancer patients with bone metastases. Methods MEDLINE, EMBASE, Cochrane Library and CBMdisc were searched for related RCTs study. Data was extracted by two reviewers using the designed extraction form. RevMan was used for data management and analysis. Results Ten RCTs were included in the study. The Meta analysis showed that Bisphosphonates relieved pain, and reduced analgesic consumption and skeletal events compared with that of control group. However, no significant difference in incidence of prostate cancer death was found between the Bisphosphonates group and the control group. A significant increase in nausea was observed in patients who received Bisphosphonates compared to that of control group. No differences in other adverse events were observed between test group and control group. Conclusion Bisphosphonates can reduce pain and skeletal events of prostate cancer patients with metastatic. Except nausea,however,other adverse events didn＇ t show a significantly increase. Further study is needed to enhance grade of these evidences. Furthermore, more research will be needed to confirm above conclusions.