化疗及靶向药物治疗肉瘤样肾癌的Meta分析

A Meta-analysis of chemotherapy and molecular targeted therapeutic drugs for sarcomatoid renal cell carcinoma

目的 系统评价化疗及靶向药物治疗肉瘤样肾癌的有效性和安全性.方法 计算机检索PubMed、中国期刊全文数据库（CN KI）等,收集2000年1月-2013年12月国内外公开发表的有关化疗及靶向药物治疗肉瘤样肾癌的试验研究文献.根据Cochrane的质量评价标准评价,采用RevMan4.2软件进行统计学分析.结果 最终纳入5个文献,共128例患者.meta分析结果显示与化疗相比,靶向药物联合化疗不但显著提高了肉瘤样肾癌的疾病控制率（OR =2.11,95％ CI：1.30 -2.61,P＜0.0001）,还显著提高了有效率（OR =2.25,95％ CI：1.53 -3.11,P＜0.0001）.结论 与化疗相比,靶向药物联合化疗可进一步提高疗效,是肉瘤样肾癌较好的治疗方案.

Objectives To evaluate the efficacy and safety of the chemotherapy and molecular targeted therapeutic drugs for sarcomatoid renal cell carcinoma treatment.Methods We searched the randomized controlled trials of chemotherapy and monotherapy for sarcomatoid cancer treatment.The database of Pubmed and China National Knowledge Infrastructure（CNKI） were included.Methodological quality of the selected trials was evaluated according to the Cochrane system and Meta analysis was utilized with RevMan 4.2 software.Results Five RCTs Totally of 128patients were identified and included in present study.Meta anlysis showed that combined application of chemotherapy and monotherapy.but not chemotherapy alone,could significantly improve the overall effective rate of treatment against advanced renal cancer,as compared with chemotherapy（OR =2.11,95 % CI：1.30 - 2.61,P 〈 0.0001）.MTTD either with or without chemotherapy,could significantly increase the disease control rate with （OR =2.25,95%CI：1.53 -3.11,P 〈0.0001）.Conclusions In comparison with chemotherapy alone,a combined application of monotherapy and chemotherapy improves overall effective rate significantly.And therefore could be used as a better therapy for the sarcomatoid renal cancer treatment.