摘要
目的靶向药物血管内皮细胞生长因子(VEGF)抗体贝伐单抗广泛应用于转移性结直肠癌的治疗,高血压为其最常见的不良反应之一。通过荟萃分析评估贝伐单抗相关高血压(BAHT)与转移性结直肠癌患者预后的关系。方法计算机检索PubMed、Embase、Cochrane Library、Web of Science、万方、CNKI、维普和CBM等数据库,对16项已发表的贝伐单抗治疗转移性结直肠癌的研究进行荟萃分析,主要终点是无进展生存期、总生存期和客观反应率。无进展生存期定义为从贝伐单抗治疗开始到临床进展或因任何原因死亡或最后一次随访(如果没有进展)之间的间隔,总生存期定义为从贝伐单抗治疗开始到死亡或最后一次随访之间的间隔,客观反应率定义为完全或部分应答的患者数量与评估患者总数的比值。从每个研究中提取无进展生存期和总生存期的风险比(HR),并估计客观反应率的相对风险比(RR)的对数,采用RevMan 5.3软件进行荟萃分析。结果BAHT的发生与转移性结直肠患者客观反应率(RR=3.49,95%CI 1.96~6.22,P<0.001)的增加、无进展生存期(HR=0.68,95%CI 0.58~0.80;P<0.001)、总生存期(HR=0.63;95%CI 0.53~0.75;P<0.001)的改善相关。结论BAHT的发生可能与转移性结直肠癌患者的远期预后改善相关。
Objective Hypertension is one of the most common adverse effects of bevacizumab,an inhibitor targeting vascular endothelial growth factors.It is widely used in the treatment of metastatic colorectal cancer.The relationship between bevacizumab-related hypertension(BAHT)and survival of patients with metastatic colorectal cancer was evaluated by meta-analysis.Methods PubMed,EMBASE,Cochrane Library,web of science,Wanfang,CNKI,VIP and CBM were searched,meta-analysis was then performed on sixteen published studies of bevacizumab in the treatment of metastatic colorectal cancer,primary endpoint was progression-free survival,overall survival and object response rate.Progression-free survival was defined as the interval between the beginning of bevacizumab treatment and clinical progression or death for any cause or the last follow-up(if no progress),overall survival was defined as the interval between the beginning of bevacizumab treatment and death or the last follow-up,and objective response rate was defined as the ratio of the number of patients who responded completely or partially to the total number of patients evaluated.Hazard ratios(HR)for progression-free survival and overall survival were extracted from each trial,and the log of the relative risk ratio(RR)was estimated for object response rate.RevMan 5.3 was used for data analysis.Results BAHT was related to the increase of objective response rate(RR=3.49,95%CI 1.96-6.22,P<0.001)and the improvement of progression-free survival(HR=0.68,95%CI 0.58-0.80,P<0.001)and overall survival(HR=0.63,95%CI 0.53-0.75,P<0.001)in metastatic colorectal cancer patients.Conclusion The occurrence of bevacizumab-related hypertension may associated with improved prognosis in patients with metastatic colorectal cancer.
作者
马丽萍
李彩娥
王琼英
余静
MA Li-ping;LI Cai-e;WANG Qiong-ying;YU Jing(Center of Hypertension,Lanzhou University Second Hospital,Gansu Lanzhou 730070,China)
出处
《中华高血压杂志》
CAS
CSCD
北大核心
2021年第2期157-163,共7页
Chinese Journal of Hypertension
基金
国家自然科学基金地区科学基金项目(81960086)
国家自然科学基金面上项目(81670385)
甘肃省卫生行业科研计划项目(GSWSKY2017-02)
甘肃省科技厅民生项目(17CXIFJ063)
兰州大学第二医院院内项目:萃英科技创新计划(2020QN-07)。
关键词
转移性结直肠癌
贝伐单抗
高血压
荟萃分析
生存期
metastatic colorectal cancer
bevacizumab
hypertension
meta-analysis
survival
