摘要
目的探讨羟基喜树碱与吡柔比星膀胱灌注预防肿瘤复发的有效性和安全性。方法计算机检索1988年1月至2013年4月期间PUBMED,EMBASE,Cochrane图书馆,CNKI,万方数据库。纳入羟基喜树碱与吡柔比星膀胱灌注预防膀胱肿瘤复发有效性和安全性的研究。对纳入研究根据Cochrane手册进行质量评价后采用Stata12软件进行Meta分析。结果共纳入13个研究,包括1 122例患者,其中羟基喜树碱组共530例,吡柔比星组共592例。对13篇研究进行Meta分析结果显示,羟基喜树碱膀胱灌注预防膀胱肿瘤复发的疗效低于吡柔比星(RR=1.446,95%CI=1.152,1.815,P<0.01)。但是羟基喜树碱膀胱灌注时血尿的发生率低于吡柔比星(RR=0.453,95%CI=0.252,0.816,P<0.01)。结论患者能耐受不良反应的情况下,与羟基喜树碱相比吡柔比星膀胱灌注预防膀胱肿瘤复发效果更好。但由于所纳入研究的质量不高,上述结论尚需高质量、大样本的随机盲法对照实验加以证实。
Objective To evaluate the effectiveness and safety of hydroxycamptothecin and pirarubicin bladder irrigation in prevention of bladder tumor recurrence. Methods The literatures were searched in Jan. 1988 to Apr. 2013 from PubMed,EMBASE, the Cochrane Library, CNKI, and Wanfang. The data were extracted, the quality of studies was evaluated according to the Cochrane systematic review guideline and meta-analysis was performed using Stata 12 software. Results A total of 13 articles were in accordance with the criteria,involving 1 122 cases,including 530 cases receiving the treatment of hydroxycamptothecin bladder irrigation and 592 cases receiving pirarubicin. Meta analysis of 13 studies showed that bydroxycamptothecin had less effect in prevention of recurrence of bladder tumor compared with the pirarubicin bladder irrigation（ RR = 1. 446,95% CI = 1. 152,1. 815, P 〈0.01）,but a lower incidence of haematuria events（RR = 0.463, 95% CI = 0.252, 0.816, P 〈 0.01）. Conclusion Pirarubicin bladder irrigation is more recommended for prevention of bladder tumor recurrence after taking into account the conditions of patients. However, more strictly-designed multi-centered randomized controlled trials with high quality in large-scale are needed to confirm this result.
出处
《临床荟萃》
CAS
2013年第11期1238-1241,1245,共5页
Clinical Focus
关键词
膀胱肿瘤
化学疗法
肿瘤
局部灌注
META分析
urinary bladder neoplasms
chemotherapy, cancer, regional perfusion
meta-analysis
