贝伐珠单抗联合化疗治疗卵巢癌腹腔积液的Meta分析

Meta-analysis of Bevacizumab Combined with Chemotherapy in the Treatment of Peritoneal Effusion of Ovarian Cancer

目的系统评价贝伐珠单抗联合化疗腹腔注射治疗卵巢癌腹腔积液的疗效和安全性。方法计算机全面检索中国生物医学文献数据库(CBM)、中国知网(CNKI)、维普(VIP)和万方(Wanfang)、The Cochrane Library、PubMed、EMbase等数据库,同时结合其他检索,收集贝伐珠单抗联合化疗腹腔注射治疗卵巢癌腹腔积液的随机对照试验(randomized controlled trials,RCTs)。依据Cochrane系统评价手册采用RevMan5.3软件进行统计分析。结果共纳入6篇RCTs,共416例患者。Meta分析结果发现,贝伐珠单抗联合化疗腹腔注射组(试验组)的完全缓解率、总有效率、疾病控制率、生活质量改善率、生活质量总稳定率均优于单纯腹腔化疗组(对照组),差异有统计学意义(P<0.05);白细胞计数减少、消化道反应、发热、血小板计数减少、血红蛋白减少、肝脏、肾功能异常、疼痛、疲乏两组发生率比较,差异无统计学意义(P>0.05)。结论与单纯腹腔化疗比较,贝伐珠单抗联合化疗腹腔注射治疗卵巢癌腹腔积液方法更优,且安全性良好,但本研究仍有不足之处,尚需开展大样本、高质量的RCT进一步验证。

Objective To evaluate the efficacy and safety of intraperitoneal injection of bevacizumab combined with chemotherapy in the treatment of peritoneal effusion of ovarian cancer.Methods Databases including CBM,CNKI,VIP,WanFang,The Cochrane Library and PubMed were searched by computer,and other searches were also supplemented.Authors collect all relevant randomized controlled trials(RCTs)about intraperitoneal injection of bevacizumab combined with chemotherapy in the treatment of peritoneal effusion of ovarian cancer.The Meta-analysis was conducted by using Review Manager 5.3 software according to Cochrane review′s book.Results Six RCTs were included with 416 patients involved.Meta-analysis showed that:compared with chemotherapeutic drugs intraperitoneal injection group alone(Control group),the intraperitoneal injection of bevacizumab combined with chemotherapy group(Experimental group)was significant superior in complete response rate,overall response rate and disease control rate,the improvement rate and total stability rate of quality of life.There were no significant differences(P>0.05)between two groups in the incidence of leucopenia,digestive tract reaction,fever,thrombocytopenia,hemoglobin reduction,liver and kidney dysfunction,pain,fatigue.Conclusion Intraperitoneal injection of bevacizumab combined with chemotherapy has better short-term efficacy,better quality of life and good safety for patients with peritoneal effusion of ovarian cancer.However,there were still some shortcomings in this study.It needs further verification by RCT with large sample size and long-term follew-up.