ω-3多不饱和脂肪酸应用于放疗患者中疗效meta分析

A meta‑analysis of the efficacy of omega‑3 polyunsaturated fatty acids in patients undergoing radiotherapy

目的系统评价ω-3多不饱和脂肪酸应用于放疗患者中的疗效。方法检索PubMed、Medline、Embase、Cochrane图书馆、中国期刊全文数据库、万方数据等数据库,检索时限至2020年5月,收集在常规饮食或标准肠内营养制剂(对照组)的基础上加用ω-3多不饱和脂肪酸(试验组)改善放疗患者营养状况和预防并发症的随机对照试验。提取符合本研究纳入标准的临床对照试验相关数据,采用Cochrane系统评价员手册5.1标准进行文献质量评价,应用Stata14.0统计软件对两组放疗前后体重丢失情况与总体并发症发生率进行meta分析。结果共纳入10项随机对照试验,合计486例患者。结果显示,两组患者放疗前后体重变化值(SMD=-0.02,95%CI:-0.26~0.21,P=0.838)、BMI变化值(SMD=0.06,95%CI:-0.23~0.34,P=0.696)、总体不良反应发生率(RR=0.97,95%CI:0.84~1.12,P=0.678)和厌食不良反应发生率(RR=0.79,95%CI:0.49~1.28,P=0.345)比较差异均无统计学意义。结论在普通膳食或常规营养制剂的基础上加用ω-3多不饱和脂肪酸并不能改善放疗患者的体重丢失和预防并发症。

Objective To systematically evaluate the efficacy ofω-3 polyunsaturated fatty acids in radiotherapy and to provide evidence-based reference for its use in radiotherapy.Methods Randomized controlled trials(RCT),which utilized the regular diet or standard enteral nutrition preparations(control group)and combined withω-3 polyunsaturated fatty acids(experimental group)to improve the nutritional status in patients during radiation therapy and prevent of complications were collected from PubMed,Medline,Embase,the Cochrane library,China journal full-text database and Wanfang database,until to May 2020.Data of clinical trials that met the inclusion criteria were extracted and quality evaluation of the trials was conducted with reference to Cochrane systematic evaluator′s manual 5.1.The Stata 14.0 statistical software was used to meta-analyze the weight loss before and after radiotherapy and the incidence of complications of severe anorexia,vomiting and diarrhea in the two groups.Results a total of 10 RCTs were included,with 486 patients.The results of meta-analysis showed that no statistically significant difference between two groups was found on weight loss(SMD=-0.02,95%CI:-0.26-0.21,P=0.838),decreased BMI value(SMD=0.06,95%CI:-0.23-0.34,P=0.696),the incidence of overalladverseevents(RR=0.97,95%CI:0.84-1.12,P=0.678),and the incidence of anorexia(RR=0.79,95%CI:-0.49-1.28,P=0.345)after radiotherapy.Conclusion The combination ofω-3 polyunsaturated fatty acids with normal diet or routine nutritional preparations did not restore weight loss and prevent adverse events in patients undergoing radiotherapy.