间歇性和持续性雄激素抑制治疗晚期前列腺癌的Meta分析

Intermittent Androgen Suppression and Continuous Androgen Suppression in the Treatment of Advanced Prostate Cancer：A Meta- analysis

目的比较间歇性雄激素抑制（intermittent androgen suppression，IAS）与持续性雄激素抑制（continuous androgen suppression，CAS）治疗中晚期前列腺癌的进展率、对患者生活质量的改善及副作用。方法采用计算机检索与手工检索相结合的方法搜索中文科技期刊数据库（CSTJ）、中国期刊全文数据库（CNKI）、维普数据库（VIP）、万方数据服务平台、Annual Reviews生物医学综述期刊、Elsevier全文电子期刊数据库、co-chrane图书馆等中英文数据库，时间从建库至2012年12月31日。收集IAS与CAS治疗晚期前列腺癌的进展率、对患者生活质量的改善及副作用的文献，对符合纳入标准的文献用RevMan5．1软件进行Meta分析。结果共纳入6篇文献，包括IAS组745例和CAS组747例。Meta分析结果显示，IAS与CAS方法治疗晚期前列腺癌的疾病进展率差异无统计学意义[OR=1．00，95％CI（0．63，1．58），P〉0．05]，IAS方法能够明显改善患者的性功能[OR=0．43，95％CI（0．24，0．77），P〈0．05]，并且能够明显减少副作用[OR=0．41，95％CI（0．22，0．77），P〈0．05]。结论IAS与CAS方法对疾病进展率的影响无明显差异，但IAS方法能够明显改善患者生活质量，减少治疗相关的副作用。

Objective To compare the progressive rate,improvement of quality of life and side effects between intermittent androgen suppression （IAS）group and continuous androgen suppression （CAS）group in the treatment of advanced prostate cancer. Methods CSTJ, CNKI, VIP, Wanfang Data Services Platform, Annual Reviews Journal of Biomedical Review and Cochrane Library were searched by computer retrieval as well as manual retrieval from data- bases establishing to Dec. 31,2012. Literature relevant to progressive rate, improvement of quality of life and side effects on treating advanced prostate cancer with IAS or CAS were collected. RevManS. 1 software was used to analyze literature which were in accordance with the inclusive criteria. Results Six articles were adopted, including 745 cases from IAS group and 747 cases from CAS group. There was no significant difference in progressive rate between IAS group and CAS group[ OR = 1.00,95% CI （ 0.63,1.58 ）, P 〉 0.05 ]. There was higher quality of life in IAS group than that in CAS group[ OR = 0.43,95% C1 （0.24,0.77） ,P 〈 0.05 ]. There were less side effects in IAS group than those in CAS group[OR =0.41,95%CI（0.22,0.77） ,P〈0.05]. Conclusion There is no significant difference in progressive rate between IAS method and CAS method. However, IAS method can significantly improve the quality of life and reduce treatment -related side effects.