甘氨双唑钠对宫颈癌放疗及同步放化疗增敏疗效的Meta分析

The efficacy and safety of sodium glysididazole for cervical cancer radiotherapy and chemoradiotherapy: a Meta-analysis

目的:系统评价甘氨双唑钠(CMNa)对宫颈癌放疗及同步放化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、Pub Med、Cochrane Library、Embase,收集放疗或同步放化疗联合CMNa与不联合CMNa治疗宫颈癌的临床随机对照研究(RCT)。根据纳入和排除标准筛选文献,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Rev Man 5.3及Stata 13.0进行Meta分析。结果:CMNa增敏治疗中晚期宫颈癌的完全缓解率高于非增敏组(OR=3.77,95%CI为2.60~5.47,P<0.001;放疗亚组:OR=6.01,95%CI为3.26~11.08,P<0.001;同步放化疗亚组:OR=2.72,95%CI为1.69~4.40,P<0.001)。CMNa增敏组达到CR的剂量低于非增敏组(SMD=-1.84,95%CI为-2.47^-1.20,P<0.001;放疗亚组:SMD=-1.54,95%CI为-2.02^-1.06,P<0.001;同步放化疗亚组:SMD=-2.71,95%CI为-3.54^-1.88,P<0.001)。CMNa增敏组与非增敏组的消化道不良反应、骨髓抑制、放射性肠炎、放射性膀胱炎、皮肤黏膜不良反应发生率比较,差异均无统计学意义。结论:CMNa对宫颈癌放疗及同步放化疗增敏作用的疗效较非增敏组好,不良反应发生率无差异,安全性好。

Objective：To assess the efficacy and safety of radiotherapy and chemora-diotherapy combined with sodium glycididazole （ CMNa） in treating cervical cancer by conduc-ting a meta-analysis. Methods：Collect randomized clinical controlled studies （ RCTs） of radio-therapy or chemoradiotherapy plus sodium glysididazole （ CMNa ） versus control group without CMNa in the treatment of cervical cancer,which were retrieved from Chinese Biomedical Data-base,Chinese periodical full text database （ CNKI ） , Wan-fang database, Database of Chinese Periodicals of Science and Technology, PubMed, Cochrane Library and Embase. According to the inclusion and exclusion criteria,data extraction and quality assessment were done by two re-searchers independently,and clinically important measures were selected. Outcomes were pooled with Revman5. 3 and Stata 13. 0. Results：The complete remission（CR） rate of the combined sodium glysididazole group was better than that of the control （ OR=3. 77,95%CI=2. 60 ~5. 47,P〈0. 001;radiotherapy subgroup：OR=6. 01,95%CI=3. 26~11. 08,P〈0. 001;chemo-radiotherapy subgroup：OR=2. 72,95%CI=1. 69 ~4. 40,P〈0. 001）. The dose needed to a-chieve CR was lower in combined sodium glysididazole group（SMD=-1. 84,95%CI=-2. 47^-1. 20,P〈0. 001;radiotherapy subgroup：SMD=-1. 54,95%CI= -2. 02^-1. 06,P〈0. 001;chemoradiotherapy subgroup：SMD=-2. 71,95%CI为-3. 54^-1. 88,P〈0. 001）. There were no significant differences in the incidence rates of gastrointestinal adverse reaction,myelosup-pression,radioactive enteritis, radiocystitis and adverse reaction of skin and mucosa. Conclu-sion：In the treatments of cervical cancer,the CR in radiotherapy and chemoradiotherapy com-bined with sodium glysididazole group are superior to radiotherapy or chemoradiotherapy alone group and less radiation dose is needed. And,the occurrence rates of adverse reactions in the two groups have no obvious differences and the safety is identified.