国内吡柔比星与表柔比星膀胱灌注Meta分析

Efficiency and Safety of Pirarubicin Versus Epirubicin Bladder Irrigation in China:A Meta-analysis

目的对国内吡柔比星与表柔比星膀胱灌注化疗预防膀胱癌复发两种手段的有效性和安全性进行系统评价。方法计算机网络查找中国生物医学文献数据库(CBM),万方中国学术期刊数据库(CSPD)和中国知网(CNKI)以及维普中文科技期刊数据库(VIP),并用手工检索辅助,检索时间均为建立数据库至2019年10月,查找所有研究比较吡柔比星(THP)与表柔比星(EPI)膀胱灌注预防膀胱癌复发的对照试验,按纳入标准和排除标准由两名研究人员独立进行选择、数据提取与质量评价分析,使用Revman 5.3系统分析软件进行Meta分析。结果纳入了7篇研究文章。系统分析结果表明:吡柔比星膀胱灌注化疗与表柔比星相比,前者减少了膀胱癌电切术后复发率,而在不良反应发生率,膀胱刺激征发生率,血尿发生率,吡柔比星与表柔比星无明显差异。结论吡柔比星与表柔比星膀胱灌注预防膀胱癌复发是安全有效的治疗手段。吡柔比星与表柔比星膀胱灌注相比,在膀胱癌电切术后复发率存在优势,而在不良反应并无明显差异。但由于该Meta分析纳入研究仅在国内,数量少,有存在选择偏倚、实施偏倚与发表偏倚的可能性,需要更多高质量、大样本的随机对照试验提供更可靠的循证医学证据。

Objective To systematically review the clinical therapeutic efficacy and safety of pirarubicin and epirubicin in prevention of recurrence of bladder tumor in China.Methods We searched CBM,CSPD,CNKI and VIP without from their establishment to October 2019 for collecting the controlled trials about pirarubicin and epirubicin in prevention of recurrence of bladder tumor in China,and the references of the controlled trials were also searched in hand.After study selection,two reviewers independently conducted assessment and data extraction,Cochrane Collaboration's RevMan 5.3 software was used for statistical analysis.Results Seven studies were included.Meta-analysis showed that pirarubicin is better than epirubicin in prevention of recurrence of bladder tumor,but no significant difference was found with regard to adverse reaction rate,incidence of bladder irritation,incidence of hematuria.Conclusion Pirarubicin and epirubicin bladder irrigation is a safe and effective method in prevention of recurrence of bladder tumor.Compared with epirubicin,pirarubicin could reduce recurrence rate of bladder tumor,without reducing other complications.Because of the small number of the included studies,which weakens the strength of the evidence of our results,there is a moderate possibility of selection bias,performance bias and publication bias in this Meta-analysis.More high-quality and large-sample studies are needed to provide further evidences in Evidence-based medicine.