榄香烯注射液联合放疗治疗肺癌脑转移的Meta分析

Meta-analysis of Elemene Injection Combined with Radiotherapy in Treating Brain Metastasis of Lung Cancer

目的系统评价榄香烯注射液联合放疗治疗肺癌脑转移的疗效及安全性。方法计算机检索Pubmed、Cochrance图书馆、EMBASE、CNKI、Wang Fang、CBM数据库,检索时间为各库建立起至2016年8月1日。纳入榄香烯注射液联合放疗治疗肺癌脑转移临床随机对照试验(RCT),由2名研究者独立进行资料提取和质量评价,依据Cochrane偏倚风险评估工具对随机对照试验进行质量评价,采用Review Manager 5.2对符合条件的文献进行Meta分析。结果最终纳入15篇RCTs,共1075例患者。Meta显示:榄香烯+放疗组与放疗组比较,在近期疗效[OR=2.98,95%CI(2.26,3.92),P=0.00001]、卡氏评分[OR=3.16,95%CI(1.87,5.33),P<0.0001]、血清MMP-2[OR=-41.96,95%CI(-43.43,-40.49),P=0.00001]、血清MMP-9[OR=-43.44,95%CI(-44.96,-41.91),P<0.00001]、消化道反应[OR=0.56,95%CI(0.45,0.69),P=0.00001]及骨髓抑制方面[OR=0.30,95%CI(0.17,0.50),P<0.00001],两组差异具有统计学意义。结论榄香烯联合放疗较单纯放疗能明显抑制肿瘤生长,减轻放疗副反应,提高患者的生活质量。此结论仍需要大样本的高质量随机对照试验进一步证实。

Abstast：Objective To evaluate the effectiveness and safety of Elemene Injection combined with radiotherapy for the treatment of brain metastasis of lung cancer.Methods The randomized controlled trials of Elemene Injection combined with radiotherapy for the treatment of brain metastasis of lung cancer issued in the Pubmed,EMBASE,Cochrane database,CNKI,Wanfang Standards Database,and CBM were selected systematically from their inception to August of 2016.The data abstraction and methodological quality evaluation were performed by two researchers independently on the basis of the Cochrane bias risk assessment tools.The Cochrane Collaboration＇s Review Manager 5.2 software was used for Meta-analysis.Results Seventeen trials were included in this study,involving in 1057 patients.The results of Meta-analysis indicated that there were significant differences of short-term effec[tOR=2.98,95 % CI（2.26,3.92）,P〈0.00001],Karnofsky score[sOR=3.16,95 % C（I1.87,5.33）,P〈0.0001],serum MMP-2 conten[tOR=-41.96,95 % CI（-43.43,-40.49）,P〈0.00001],serum MMP-9 leve[lOR=-43.44,95 % CI（-44.96,-41.91）,P〈0.00001],digestive tract reaction [OR=0.56,95 % CI（0.45,0.69）,P〈0.00001]and bone marrow depression[OR=0.30,95 % CI（0.17,0.50）,P〈0.00001] between Elemene Injection plus radiotherapy group and radiotherapygroup.Conclusion Elemene Injection combined with radiotherapy is more effective on significantly inhibiting the growth of tumor,reducing the side effects of radiotherapy and improving the quality of life of patients than radiotherapy alone.This conclusion still needs to be further confirmed by large sample randomized controlled trials.