不同化疗方案对晚期初治卵巢癌术后患者早期临床疗效及安全性荟萃分析

Meta-analysis of the early clinical efficacy and safety of different chemotherapy regimens for postoperative patients with advanced primary ovarian cancer

目的探讨不同化疗方案在晚期初治卵巢癌术后患者早期临床治疗效果及安全性。方法对电子数据库进行计算机检索,对灰色文献进行手工检索。检索词为:化疗方案*卵巢癌;紫杉醇*(洛铂+卡铂)*卵巢癌;铂类*卵巢癌。检索时间截至2016年12月。由安丘市人民医院2位专业评价员分别对入选的文献质量、数据提取及交叉等进行核对、验证,采用RevMan 5.2软件进行荟萃分析(meta-analysis)。结果初检相关中文文献11篇,未检出灰色文献,最终纳入5篇RCT;经过异质性检验χ~2=4.45,自由度df=4(P>0.05),I^2=12%,表明纳入的研究不具有异质性。采用固定效应模型综合结果显示:OR(95%CI)为0.91(0.83,1.01)(P>0.05)。经过异质性检验χ~2=6.52,自由度df=3(P>0.05),I^2=54%,表明纳入的研究不具有异质性。因此,采用固定效应模型,综合结果显示:OR(95%CI)为1.01(0.81,1.25)(P>0.05)。结论从目前证据来看,不同化疗方案对晚期初治卵巢癌术后患者早期均具有良好的疗效,且药物毒性尚能耐受,可以根据患者情况制定针对性化疗方案。

Objective To investigate the clinical efficacy and safety of different chemotherapy regimens in the early stage of patients with advanced ovarian cancer after surgery.Methods Manual search was performed on grey literature using computer to electronic databases.The search terms are:Chemotherapy regimen*Ovarian cancer;paclitaxel*(lobaplatin+carboplatin)*Ovarian cancer;Platinum*Ovarian cancer.The search time is as of December 2016.Two professional evaluators from the Anqiu People's Hospital checked and verified the quality of the selected documents,data extraction and crossover,and used RevMan 5.2 software for meta-analysis.Results There were 11 Chinese articles in the initial examination,grey literature was not detected,and finally 5 RCTs were included;after heterogeneity test=4.45,the degree of freedom df=4(P>0.05),I 2=12%,indicating that Research does not have heterogeneity.The combined results using the fixed-effect model showed that OR(95%CI)was 0.91(0.83,1.01)(P>0.05).After heterogeneity test=6.52,the degree of freedom df=3(P>0.05),I 2=54%,which indicates that the included studies are not heterogeneous.Therefore,using a fixedeffects model,the overall results showed:OR(95%CI)was 1.01(0.81,1.25)(P>0.05).Conclusions From the current evidence,different chemotherapy regimens have good efficacy in the early stage of patients with advanced ovarian cancer after surgery,and drug toxicity can still be tolerated.According to the patient's situation,targeted chemotherapy regimens can be developed.