舒尼替尼治疗转移性肾癌疗效的Meta分析

Meta-Analysis of Sunitinib Therapy for Metastatic Renal Cell Carcinoma

目的:对舒尼替尼治疗转移性肾癌的疗效进行系统评价。方法:采取Cochrance系统评价方法,检索Cochrance图书馆(2005-2014)、Pubmed(2000年1月-2014年2月)、EMBASE(1991年1月-2014年2月)、中国知网(2000年1月-2014年2月)和万方数据库(2000年1月-2014年2月)等数据库有关舒尼替尼与干扰素或IL-2治疗转移性肾癌进展的随机对照临床试验的文献纳入研究。采用RevMan 5.2软件对提取资料中纳入研究进行meta分析。结果:共有3篇文献符合纳入标准,共984例患者。Meta分析结果显示:与对照组相比舒尼替尼在缓解肿瘤方面存在优势[OR=3.79,95%CI(2.59,5.54),P<0.000 01]。舒尼替尼与对照组发生严重不良反应有统计学差异[OR=0.62,95%CI(0.39,0.99),P≤0.05],舒尼替尼较对照组发生严重不良反应相对较少。结论:与对照组相比舒尼替尼单用能更有效缓解肿瘤,而不增加严重不良药物反应风险。

Objective：To evaluate the efficacy and safety of sunitinib for metastatic renal cell carcinoma.Methods：We searched the Cochrane Library,Pubmed,EMBASE,CNKI and WANFANG DATA from the establishment of each database to February 2014.Database related to randomized controlled trials（RCTs）comparing sunitinib with interferon or IL-2treatment of metastatic renal cell carcinoma was included in the study.Both the study selection and the meta-analysis were conducted according to the Cochrane Handbook for systematic reviews.Data were extracted from these trials and analyzed by RevMan 5.2software.Results：Three RCTs involving 984 patients were identified.According to the different interventions for metastatic renal cell carcinoma,results from meta-analysis showed the sunitinib＇s benefit on treatment of metastatic renal cell carcinoma compared with control group（OR=3.79,95%CI[2.59,5.54],P〈0.000 01）.Incidences of drug-related serious adverse events were statistical difference between sunitinib and control group（OR=0.62,95%CI[0.39,0.99],P ≤0.05）.The proportion of patients with serious adverse events was higher in the control group.Conclusion：Compared with control group,sunitinib could inhibit tumor progression more effectively and it would not increase the risk of serious adverse events.