促性腺激素释放激素类似物联合化疗治疗绝经前早期乳腺癌患者Meta分析

Adjuvant Chemotherapy Followed by Gonadotropin-Releasing Hormone Analog for Premenopausal Early Stage Breast Cancer:A Meta-Analysis

[目的]系统评价促性腺激素释放激素类似物联合化疗治疗早期绝经前乳腺癌患者的有效性。[方法]数据库检索国内外1996～2018年发表的促性腺激素释放激素类似物(gonadotropin-releasing hormone analog,GnRHa)联合化疗治疗早期绝经前乳腺癌患者的前瞻性随机对照临床试验研究,对符合纳入标准的研究使用Jadad评分进行文献质量评价,并使用STATA 12.0软件进行meta分析。[结果]共纳入5项Ⅲ期随机对照临床试验。Meta分析结果显示,与单纯化疗相比,GnRHa联合化疗治疗早期绝经前乳腺癌患者不能延长其无病生存期(HR=0.880,95%CI:0.769～1.006,P=0.06),但能延长总生存期(HR=0.808,95%CI:0.660～0.988,P=0.038)。[结论 ] GnRHa联合化疗治疗早期绝经前乳腺癌患者优于单纯化疗,但尚需要进一步研究。

[Objective]To systematically evaluate the efficacy of gonadotropin-releasing hormone analog(GnRHa)combined with adjuvant chemotherapy in premenopausal women with early stage breast cancer.[Methods]The prospective random control trials comparing adjuvant chemotherapy with or without GnRHa for premenopausal women with early stage breast cancer published in the domestic and overseas during 1996 to 2018 were searched.Jadad grading standard was used to appraise the quality of the included studies.STATA 12.0 was used to conduct the Meta-analysis.[Results]With 5 eligible phaseⅢrandomized controlled clinical trials identified,the analysis demonstrated that premenopausal women with early stage breast cancer did not benefit in disease-free survival(DFS)(HR=0.880,95%CI:0.769~1.006,P=0.06],but derived benefit in overall survival(HR=0.808,95%CI:0.660~0.988,P=0.038]from the addition of GnRHa to adjuvant chemotherapy.[Conclusion]GnRHa combined withadjuvant chemotherapy may improve the overall survival for premenopausal patients with early stage breast cancer.