89Srcl2联合唑来膦酸治疗肺癌骨转移的Meta分析

Meta-analysis of the efficacy and safety of 89Srcl2 combined with zoledronic acid in the treatment of lung cancer with bone metastasis

目的系统性评价89Srcl2(氯化锶)联合唑来膦酸治疗肺癌骨转移的临床效果及毒副反应。方法计算机网络检索中英文医学数据库(Pubmed、Web of science、Ovid、EMbase、Cochrane library、中国知网、万方数据库、维普数据库、中国生物医学文献数据库),筛选89Srcl2联合唑来膦酸治疗肺癌骨转移患者的随机对照实验(randomized controlled trials,RCT),搜索起止时间为建库至2020年4月30日,对联合用药组及单药组的骨痛缓解率、骨转移灶控制率、不良反应发生率、首次骨相关事件(SREs)及总生存期(OS),利用RevMan 5.3软件进行Meta分析。结果纳入了7篇文献共555名患者,联合组的骨痛缓解率既优于单用唑来膦酸组(P=0.03)又优于单用89Srcl2组(P=0.04),骨转移灶控制率既要优于唑来膦酸组(P=0.0003),也要优于89Srcl2组(P=0.006),联合组较单用89Srcl2组延长了首次发生SREs的时间(P=0.008)及1年总生存期(P=0.0036)。联合组在毒副反应发生率方面与唑来膦酸组(P=0.79)及89Srcl2组(P=0.97)之间无显著统计学差异。结论89Srcl2联合唑来膦酸治疗肺癌骨转移的近期及远期疗效优于单药组,毒副反应相对无增加,联合用药可以作为肺癌骨转移患者的优先治疗方案。

Objective To systematically evaluate the clinical effects and side effects of 89Srcl2(Strontium chloride)combined with zoledronic acid in the treatment of bone metastasis of lung cancer.Methods Computer network was used to retrieve both English and Chinese medical databases(Pubmed,Web of science,Ovid,EMbase,the Cochrane library,CNKI,Wanfang database,Weipu database,CBM),screening 89Srcl2 combined zoledronic acid treatment of lung cancer patients with bone metastases of randomized controlled trials(RCT),starting and ending time search for libraries to April 30,2020.RevMan 5.3 was used for Meta-analysis of bone pain relief rate,bone metastasis control rate,incidence of adverse reactions,first bone-related events(SREs),and overall survival(OS)in the combined and single drug groups.Results The included 7 articles were a total of 555 patients,and the remission rate of bone pain in the combined group was better than that of the zoledronic acid group alone(P=0.03)and that of the 89Srcl2 group alone(P=0.04),bone metastases control was superior to both zoledronic acid group(P=0.0003),and it was better than 89 srcl 2 group(P=0.006),the joint group extended the SREs first took place in the 89 srcl 2 alone group(P=0.008),and 1 year time overall survival(P=0.0036).There was no statistically significant difference in the incidence of adverse reactions between the combined group and the zoledronic acid group(P=0.79)and the 89Srcl2 group(P=0.97).Conclusion The short-term and long-term efficacy of 89Srcl2 combined with zoledronic acid in the treatment of bone metastasis of lung cancer is better than that of the single drug group,and the side effects are relatively not increased.