奈达铂联合紫杉醇同步放化疗治疗中晚期宫颈癌疗效与安全性的meta分析

Meta-analysis on the efficacy and safety of concurrent radiotherapy with nedaplatin+paclitaxel for the treatment of middle-late cervical cancer

目的系统评价奈达铂联合紫杉醇同步放化疗治疗中晚期宫颈癌的效果与安全性。方法在中国知网、万方数据库、维普、中国生物医学文献数据库、Medline数据库、EMbase、PubMed、Web of Science中检索有关中晚期宫颈癌应用奈达铂联合紫杉醇同步放化疗治疗的随机对照试验(RCT),检索时限截至2022年7月,两名研究员独立阅读、筛选、提取资料并评价质量后,采用RevMan 5.4软件进行meta分析。结果共纳入22项RCT试验共计1627例患者,meta分析结果显示,与单纯放疗相比,奈达铂联合紫杉醇同步放化疗可显著提高患者的近期疗效[RR=1.59,95%CI(1.44,1.74),P<0.00001]和总生存率[RR=1.29,95%CI(1.21,1.37),P<0.00001];安全性指标差异均无统计学意义(P>0.05)。结论对于中晚期宫颈癌,奈达铂联合紫杉醇同步放化疗效优安全,可作为未来中晚期宫颈癌放化疗方案的新选择。但文章仍存在诸多局限性,有待更多高质量RCTs进一步验证并丰富研究结果。

Objective To systematically assess the efficacy and safety of concurrent radiotherapy with nedaplatin+paclitaxel for the treatment of middle-late cervical cancer.Methods Randomized controlled trials(RCT)on concurrent radiotherapy with nedaplatin+paclitaxel for the treatment of middle-late cervical cancer included in China National Knowledge Internet,Wanfang,VIP,China Biology Medicine disc,Medline database,EMbase,PubMed and Web of Science were retrieved with a retrieve time frame up to July 2022.After reading,screening,extracting information and evaluating quality on the retrieved RCT by 2 investigators independently,a Meta-analysis was performed using RevMan 5.4 software.Results A total of 22 RCT with 1627 patients were included.The results of Meta-analysis showed that,compared with radiotherapy alone,concurrent radiotherapy with nedaplatin+paclitaxel significantly improved the short-term efficacy(RR=1.59,95%CI[1.44,1.74],P<0.00001)and overall survival(RR=1.29,95%CI[1.21,1.37],P<0.00001).No statistically significant differences were found in safety indicators(P>0.05).Conclusion Concurrent radiotherapy with nedaplatin+paclitaxel is of ideal efficacy and safe for patients with middle-late cervical cancer,and can be a new option of radiotherapy regimen for middle-late cervical cancer in the future.However,this article still has many limitations,and more high-quality RCTs are needed to furt her validate and enrich the study findings.