甘氨双唑钠对鼻咽癌放疗增敏作用的Meta分析

Effectiveness and safety of sodium glycididazole for nasopharyngeal carcinoma radiotherapy： a Meta-analysis

目的探讨甘氨双唑钠（CMNa）对鼻咽癌放疗增敏作用的临床疗效和安全性。方法检索中国生物医学文献数据库、中国期刊全文数据库（CNKI）、万方医药期刊全文数据库、中文科技期刊数据库、PubMed和Cochrane图书馆，收集放疗联合CMNa与单纯放疗治疗鼻咽癌的临床随机对照研究（RCT）。根据纳入排除标准筛选文献，对符合条件的RCT由两位研究者独立进行资料提取和质量评价后，采用Cochrane协作网提供的RevMan 5.2进行Meta分析。结果放疗联合CMNa对中晚期鼻咽癌原位灶增敏治疗CR率是单纯放疗的1.41倍，RR=1.41，95%CI为1.30～1.52，Z=8.20，P=0.00；颈淋巴结转移灶CR率是单纯放疗的1.45倍，RR=1.45，95%CI为1.30～1.62，Z=6.50，P=0.00。皮肤（RR=0.97，95%CI为0.87～1.08，Z= 0.57，P=0.57 ）、黏膜（RR=1.03，95%CI为0.93～1.15，Z=0.65，P=0.52 ）、白细胞减少（RR=0.84，95%CI为0.56～1.25，Z=0.87，P=0.38）不良反应两组差异均无统计学意义。结论放疗联合CMNa治疗中晚期鼻咽癌无论是原发灶还是颈淋巴转移灶均较单纯放疗效果好，而不良反应的发生率并无差异。

ObjectiveTo assess the efficacy and safety of radiotherapy combined with sodium glycididazole （CMNa） in treating nasopharyngeal carcinoma by conducting a Metaanalysis. MethodsRandomized clinical controlled studies （RCTs） of radiotherapy plus CMNa versus radiotherapy alone in the treatment of nasopharyngeal carcinoma were retrieved from China Biology Medicine disc, China National Knowledge Infrastructure, digital journal of Wanfang Data, China Science and Technology Journal Database, PubMed and Cochrane Library. According to the inclusion and exclusion criteria, data extraction and quality assessment were done by two researchers independently, and clinically important measures were selected. Outcomes were pooled with RevMan 5.2. ResultsThe rate of complete remission （CR） in the radiotherapy combined CMNa group was better than that in the radiotherapy alone group in 1.41 multiple to primary lesion, RR=1.41, 95%CI： 1.301.52, Z=8.20, P=0.00. To lymphonodi cervicales metastasis, the rate of CR in the radiotherapy combined CMNa group was better than that in the radiotherapy alone group in 1.45 multiple, RR=1.45, 95%CI： 1.301.62, Z=6.50, P=0.00. There were no significant differences in the incidence rates of adverse reactions of skin （RR=0.97, 95%CI： 0.871.08, Z= 0.57, P=0.57 ）, mucosa （RR=1.03, 95%CI： 0.931.15, Z=0.65, P=0.52 ） and decrease in white blood cells （RR=0.84, 95%CI： 0.561.25, Z=0.87, P=0.38）. ConclusionIn the treatments of nasopharyngeal carcinoma, the rates of CR of primary lesion and lymphonodi cervicales metastasis in radiotherapy combined with CMNa group are superior to the radiotherapy alone group. However, the occurrence rates of adverse reactions in the two groups have no obvious differences.