来曲唑治疗绝经后妇女乳腺癌疗效的系统评价

Efficacy of Letrozole in the Treatment of Breast Cancer in Postmenopausal Women:A Systematic Review

目的:系统评价来曲唑治疗绝经后妇女乳腺癌的疗效。方法:采用Cochrane系统评价方法,检索Cochrane图书馆,PubMed、CNKI及CBMdisc等数据库。纳入来曲唑治疗绝经后妇女乳腺癌的随机对照试验(RCT),并逐篇进行质量评价和资料提取。统计学数据采用RevMan5.0软件进行处理。结果:共纳入6个RCT,患者6316例。术后辅助内分泌治疗中,来曲唑在增加无病进展存活率方面,显示优于他莫昔芬的疗效,但二者总体生存率差异无统计学意义;在复发或转移后的解救治疗中,来曲唑在总体生存率、无病进展存活率、客观反应率方面,均显示优于他莫昔芬的远期疗效;在术前新辅助内分泌治疗中,来曲唑在增加客观反应率方面,显示优于他莫昔芬的疗效。结论:目前证据表明,来曲唑在各种乳腺癌内分泌治疗方式中,均显示出优于他莫昔芬的疗效。期待更多高质量、大样本的RCT,以提供更可靠的证据。

OBJECTIVE：To evaluate efficacy of letrozole in the treatment of breast cancer in postmenopausal women. METHODS：RCTs about letrozole in the treatment of breast cancer in postmenopausal women were collected using Cochrane systematic evaluation method by retrieving from Cochrane Library,PubMed,CBMdisc and CNKI. The quality evaluation of those trials and data extraction were performed and Meta-analysis was conducted by RevMan 5.0 software. RESULTS：6 RCTs involving 6 316 patients were included. In neoadjuvant endocrine therapy,letrozole was more effective than tamoxifen in PFS but there was no statistical significance in difference of total survival rate;in rescue therapy for recurrence and transform,letrozole was more effective than long-term therapy of tamoxifen in OS,PFS and OR;in new neoadjuvant endocrine therapy before operation,letrozole was more effective than tamoxifen in OR. CONCLUSION：The current evidence shows that letrozole is more effective than tamoxifen for breast cancer in postmenopausal women.More high-quality clinical trials are expected for further study.