恩度联合同步放化治疗宫颈癌疗效的Meta分析

Meta-analysis of Efficacy of Endostar Combined with Concurrent Chemoradiotherapy for the Treatment of Cervical Cancer

目的对恩度联合同步放化疗治疗宫颈癌的临床疗效及安全性进行系统评价。方法对中文数据库中国知网(CNKI)、万方(Wanfang)、维普(VIP)、中国生物医学文献数据库(CBM)及英文数据库PubMed、Cochrane图书馆、Embase进行检索,收集并筛选2005年1月1日~2021年10月19日期间关于恩度联合同步放化疗治疗宫颈癌的随机对照试验的相关临床研究进行Meta分析。采用RevMan 5.4软件分析患者的完全缓解(complete response,CR)、客观缓解率(objective response rate,ORR)、疾病控制率(disease control rate,DCR)以及不良反应发生率。结果最终纳入7篇研究,共498例患者。Meta分析结果显示,恩度联合同步放化疗可以提高宫颈癌患者的CR(OR=2.45,95%CI:1.59~3.77,P<0.0001)、ORR(OR=3.29,95%CI:1.90~5.70,P<0.0001)和DCR(OR=3.04,95%CI:1.51~6.15,P=0.002),且在各不良反应如白细胞计数减少(OR=0.77,95%CI:0.42~1.40,P=0.39)、血小板计数下降(OR=0.76,95%CI:0.40~1.46,P=0.42)、腹泻(OR=0.71,95%CI:0.42~1.20,P=0.20)、泌尿生殖系统不良反应(OR=0.72,95%CI:0.34~1.49,P=0.37)等的发生率与单纯同步放化疗比较,差异均无统计学意义。结论与单纯同步放化疗比较,恩度联合同步放化疗可显著改善宫颈癌患者的CR、ORR和DCR,且两种方法的主要不良反应事件发生率相似。

Objective To systematically evaluate the clinical efficacy and safety of Endostar combined with concurrent chemoradiotherapy in the treatment of cervical cancer.Methods Chinese databases including CNKI,Wanfang,VIP,CBM,and English databases including PubMed,Cochrane Library,Embase and other databases were searched.Randomized controlled trials of Endostar combined with concurrent chemoradiotherapy in the treatment of cervical cancer from January 1,2005 to October 19,2021 were collected and screened for Meta-analysis.complete response(CR),objective response rate(ORR)and disease control rate(DCR)and incidence of adverse reactions were analyzed by RevMan 5.4software.Results Totally 7studies involving 498 participants were included.Meta-analysis showed that the Endostar combined with concurrent chemordnance could improve CR(OR=2.45,95%CI:1.59-3.77,P<0.0001),ORR(OR=3.29,95%CI:1.90-5.70,P<0.0001)and DCR(OR=3.04,95%CI:1.51-6.15,P=0.002).In addition,and adverse reactions such as leukopenia(OR=0.77,95%CI:0.42-1.40,P=0.39),thrombocytopenia(OR=0.76,95%CI:0.40-1.46,P=0.42),diarrhea(OR=0.71,95%CI:0.42-1.20,P=0.20)and the incidence of urogenital side effects(OR=0.72,95%CI:0.34-1.49,P=0.37)had no significant difference compared with the oncurrent chemoradiotherapy.Conclusion Compared with concurrent chemoradiotherapy alone,Endostar combined with concurrent chemoradiotherapy can significantly improve the CR,ORR and DCR in patients with cervical cancer,and the incidence of major adverse events is similar in both methods.