摘要
目的:系统评价氨磷汀预防化疗致周围神经毒性(CIPN)的疗效和安全性,为临床提供循证参考。方法:计算机检索PubMed、EMBase、Cochrane图书馆、中国期刊全文数据库、万方数据库和中文科技期刊数据库,收集氨磷汀联合化疗(试验组)对比单纯化疗(对照组)用于肿瘤患者的随机对照试验(RCT),资料提取并采用改良的Jadad评分量表评价质量后,采用RevMan 5.3统计软件进行Meta分析。结果:共纳入20项RCT,合计1 552例患者。Meta分析结果显示,试验组患者CIPN总发生率[RR=0.57,95%CI(0.45,0.72),P<0.001]、严重CIPN发生率[RR=0.47,95%CI(0.32,0.69),P<0.001]显著低于对照组,恶心发生率[RR=1.31,95%CI(1.03,1.67),P=0.03]、呕吐发生率[RR=2.28,95%CI(1.14,4.54),P=0.02]及低血压发生率[RR=28.29,95%CI(10.53,76.04),P<0.001]显著高于对照组,差异均有统计学意义;两组患者客观缓解率比较,差异无统计学意义[RR=1.08,95%CI(0.98,1.19),P=0.14]。结论:氨磷汀能有效预防肿瘤患者化疗致CIPN的发生,且不影响化疗疗效,但会加重患者化疗后恶心、呕吐的发生,并易诱发低血压。
OBJECTIVE： To systematically review the efficacy and safety of amifostine in preventing chemotherapy-induced pe- ripheral neurotoxicity （CIPN）, and provide evidence-based reference for clinical treatment. METHODS： Retrieved from PubMed, EMBase, Cochrane Library, CJFD, Wanfang and VIP Database, randomized controlled trials （RCT） about amifostine combined with chemotherapy （test group） versus chemotherapy alone （control group） in preventing CIPN were collected. Meta-analysis was performed by using Rev Man 5.3 software after data extraction and quality evaluation by modified Jadad score. RESULTS： Totally 20 RCTs were included, involving 1 552 patients. Results of Meta-analysis showed, the total incidence of CIPN [RR=0.57,95%CI （0.45,0.72） ,P〈0.001] and incidence of serious CIPN [RR=0.47,95%CI（0.32,0.69）,P〈0.001] in test group were significantly lower than control group, the incidences of nausea [RR=1.31,95%CI（1.03,1.67） ,P=0.03], vomiting [RR-~2.28,95%CI（1.14, 4.54）, P=0.02] and hypotension [RR=28.29,95% CI （10.53,76.04）, P〈0.001] were significantly higher than control group, with statistic significance; and there was no significant difference in objective response rate [RR---- 1.08,95 % CI （0.98, 1.19）, P= 0.14]. CONCLUSIONS： Amifostine can effectively prevent the incidence of CIN and does not affect chemotherapy efficacy, whereas can increase the incidence of nausea and vomiting and easily induce hypotension.
出处
《中国药房》
CAS
北大核心
2017年第3期364-368,共5页
China Pharmacy
基金
天津市卫生局科技基金项目(No.2014KY09)
关键词
氨磷汀
化疗
预防
神经毒性
系统评价
疗效
安全性
Amifostine
Chemotherapy
Prevention
Neurotoxicity
Systematic evaluation
Efficacy
Safety
