鼻咽癌病人放疗相关性口腔黏膜炎危险因素的Meta分析

Risk factors of radiotherapy-related oral mucositis in patients with nasopharyngeal carcinoma:a Meta-analysis

目的:探讨鼻咽癌病人放疗相关性口腔黏膜炎的危险因素。方法:计算机检索Web of Science、the Cochrane Library、PubMed、EMbase、中国知网、万方数据库、维普数据库和中国生物医学文献数据库等关于鼻咽癌病人放疗相关性口腔黏膜炎危险因素的文献,检索时限为建库至2021年5月1日,由2位研究者筛选文献、提取资料,并进行质量评价。采用RevMan 5.3软件进行Meta分析。结果:共纳入19篇文献。Meta分析结果显示,同步化疗[OR=3.86,95%CI(2.98,4.99),Z=10.29,P<0.00001]、口腔pH<7[OR=1.61,95%CI(1.13,2.29),Z=2.66,P=0.008]、吸烟[OR=2.02,95%CI(1.57,2.61),Z=5.41,P<0.00001]、口腔卫生状况差[OR=2.18,95%CI(1.36,3.49),Z=3.22,P=0.001]、糖尿病[OR=6.75,95%CI(3.01,15.14),Z=4.63,P<0.00001]、白细胞减少[OR=7.63,95%CI(3.83,15.19),Z=5.79,P<0.00001]、体重减轻≥5 kg[OR=4.83,95%CI(1.81,12.90),Z=3.14,P=0.002]是鼻咽癌病人放疗相关性口腔黏膜炎的危险因素。结论:现有证据表明,同步化疗、口腔pH<7、吸烟、口腔卫生状况差、糖尿病、白细胞减少、体重减轻≥5 kg是鼻咽癌病人放疗相关性口腔黏膜炎的危险因素。但受纳入研究数量和质量限制,结论尚需开展更多高质量研究予以验证。

Objective:To investigate the risk factors of radiotherapy-related oral mucositis in patients with nasopharyngeal carcinoma.Methods:Literature on the risk factors of radiotherapy-related oral mucositis in patients with nasopharyngeal carcinoma was retrieved from Web of Science,the Cochrane Library,PubMed,EMbase,CNKI,WanFang Database,VIP and CBM.The search time limit was from the establishment of each database to May 1,2021.Literature screening,data extraction,and quality evaluation were carried out by two researchers.RevMan 5.3 software was used for Meta-analysis.Results:A total of 19 articles were included.Meta-analysis results showed that synchronous chemotherapy[OR=3.86,95%CI(2.98,4.99),Z=10.29,P<0.00001],oral pH<7[OR=1.61,95%CI(1.13,2.29),Z=2.66,P=0.008],smoking[OR=2.02,95%CI(1.57,2.61),Z=5.41,P<0.00001],poor oral health[OR=2.18,95%CI(1.36,3.49),Z=3.22,P=0.001],diabetes[OR=6.75,95%CI(3.01,15.14),Z=4.63,P<0.00001],leukopenia[OR=7.63,95%CI(3.83,15.19),Z=5.79,P<0.00001],weight loss≥5 kg[OR=4.83,95%CI(1.81,12.90),Z=3.14,P=0.002]were the risk factors of radiotherapy-related associated oral mucositis in nasopharyngeal carcinoma patients.Conclusions:Existing evidence indicates that synchronous chemotherapy,oral pH<7,smoking,poor oral health,diabetes,leucopenia,weight loss≥5 kg are the risk factors for radiotherapy-related oral mucositis in nasopharyngeal carcinoma patients.However,due to the limitations of the number and quality of the included studies,the conclusion needs to be verified by more high-quality studies.