甘氨双唑钠联合放疗治疗鼻咽癌的有效性和安全性的系统评价

Systematic Review of Effectiveness and Safety of Sodium Glycididazole Combined with Radiotherapy in the Treatment of Nasopharyngeal Carcinoma

目的:系统评价甘氨双唑钠联合放疗治疗鼻咽癌的有效性和安全性。方法:计算机检索Cochrane Library、PubMed、EMBase、中国期刊全文数据库、维普中文科技期刊数据库、中国生物医学文献数据库、万方数据库;手工检索其他相关杂志。纳入甘氨双唑钠联合放疗对比单纯放疗治疗鼻咽癌患者的随机对照试验(RCT),应用Rev Man 5.0统计软件进行Meta分析。结果:共纳入36项RCT,合计2 715例患者。Meta分析结果表明,试验组放疗结束时鼻咽部原发肿瘤[RR=1.40,95%CI(1.32,1.49),P<0.05]、转移淋巴结肿瘤的完全缓解率[RR=1.42,95%CI(1.31,1.55),P<0.05]显著高于对照组,两组比较差异有统计学意义;放疗结束时达到完全缓解率的鼻咽部原发肿瘤[MD=-11.95,95%CI(-13.85,-10.05),P<0.05]和淋巴结转移肿瘤接受的放疗剂量[MD=-9.85,95%CI(-11.53,-7.62),P<0.05]亦显著低于对照组,差异具有统计学意义;在不良反应发生率方面,两组比较差异无统计学意义[MD=0.97,95%CI(0.82,1.15),P=0.074]。结论:甘氨双唑钠联合放疗治疗鼻咽癌,近期疗效优于单纯放疗,且可以减少放疗剂量,同时不增加不良反应发生率。因纳入研究质量不高,该结论尚需高质量、设计严谨的RCT进一步证实。

OBJECTIVE： To evaluate the effectiveness and safety of sodium glycididazole combined with radiotherapy in the treatment of nasopharyngeal carcinoma. METHODS： RCTs were retrieved from Cochrane library, PubMed, EMBase, CNKI, VIP, CBM, Wanfang database; other relevant journals were searched manually. RCTs about sodium glycididazole combined with radiotherapy in the treatment of nasopharyngeal carcinoma were included. The quality of included studies was evaluated and performed by using Rev Man 5.0 statistical software. RESULTS： A total of 36 RCTs were included, involving 2 715 patients. Me ta-analysis showed that complete remission （CR） of nasopharyngeal carcinoma [RR= 1.40,95 % CI （1.32,1.49）, P〈 0.05] and lymph node metastases tumor [RR=1.42,95%CI（1.31,1.55）, P〈0.05] in trial group were significantly higher than in control group at the end of radiotherapy. At the end of radiotherapy, radiation dose for CR of original tumor [MD=11.95,95 % CI（- 13.85, -10.05）, P〈 0.05] and lymph metastasis tumor in trial group[MD = - 9.85,95 % CI （ - 11.53, - 7.62）, P〈0.05], receiving sodium glycididazole, was significantly lower than in control group. The incidence of ADR in both group had no significant difference[MD=0.97, 95%CI（0.82, 1.15）, P=0.074]. CONCLUSIONS： Shortterm efficacy of sodium glycididazole combined with radiotherapy is better than radiotherapy alone for nasopharyngeal carcinoma, at the same time, reduce radiation dose and has no effect on the incidence of ADR. Due to low quality of included studies, high quality and largescale RCT are required for further study.