西妥昔单抗联合同期放化疗对中晚期鼻咽癌疗效及毒性的meta分析

Meta-analysis of the efficacy and toxicity of cetuximab plus concurrent chemo-radiotherapy for advanced nasopharyngeal carcinoma

目的：通过回顾性分析以及meta分析比较中晚期鼻咽癌患者接受西妥昔单抗联合放化疗与单纯放化疗的疗效与毒性差异。方法：计算机检索PubMed、The Oxford Journals Collection、Elsevier Clinicalkey and Web of Science、中国期刊全文数据库（CNKI）、万方数据资源系统、中国生物医学文献数据库（CBM）等,RevMan 5.0软件完成Meta分析。结果：2013-2016年共7项随机对照试验,371例鼻咽癌患者被纳入分析,与单纯放化疗组相比,西妥昔单抗联合放化疗组的完全缓解率（complete response,CR）、客观缓解率（objective response rate,ORR）和疾病控制率（disease control rate,DCR）有明显提高,疾病稳定、疾病进展率有明显降低,但西妥昔单抗联合放化疗组的皮疹、放射性咽喉炎发生率更高,两组的其他副反应无显著性差异。结论：西妥昔单抗联合放化疗能提高鼻咽癌患者的完全缓解率、客观缓解率以及疾病控制率,除皮疹、放射性咽喉炎外无更明显的毒性。

Objective： hTis meta-analysis was performed to compare the effcacy and toxicity of cetuximab plus concurrent chemo-radiotherapy （CCRT） with CCRT alone for advanced nasopharyngeal carcinoma （NPC）.Methods：hTe related literature were retrieved and reviewed from the followed electronic databases： PubMed, hTe Oxford Journals Collection, Elsevier Clinicalkey and Web of Science, Chinese National Knowledge Infrastructure （CNKI）, WANFANG DATA, China Biology Medicine （CBM）, etc. Review manager 5.0 software was applied for statistical analysis.Results：From 2013 to 2016, a total of eight randomized control trials with 371 patients were recruited for analysis. Compared with CCRT alone, cetuximab combined with CCRT revealed significant improvement of complete response （CR）, objective response rate （ORR） and disease control rate （DCR）. Meanwhile, the rates of stable disease （SD） and progression disease （PD） were both declined dramatically. However, adding cetuximab was associated with higher incidence of rash and radiation-induced laryngopharyngitis. There was no significant difference of other side effects between two groups.Conclusion： Cetuximab plus CCRT can improve CR, ORR and DCR in patients with advanced NPC, and the toxicity profiles are no different except for the incidence of rash and radiation-induced laryngopharyngitis.