摘要
目的系统评价醋酸甲地孕酮对晚期肿瘤患者生活质量的改善效果及安全性。方法采用计算机检索PubMed,The Cochrane Library,ClinicalTrials.gov,Web of Science,Embase及中国知网(CNKI)、中国生物医学文献系统(CBM)、万方(WanFang)数据库中2012年至2022年有关醋酸甲地孕酮治疗晚期肿瘤和厌食症-恶病质综合征的研究,根据纳入和排除标准筛选文献,分别采用Cochrane系统评价工具和非随机对照研究报告规范(TREND)评价随机对照试验(RCT)和类实验研究(QES)的质量和偏倚风险,采用RevMan 5.3软件进行Meta分析。结果共纳入24项研究,涉及1815例患者,包括5项RCT和19项QES。Meta分析结果显示,与仅接受常规治疗组比较,接受常规治疗+醋酸甲地孕酮组患者的体质量显著增加[OR=7.04,95%CI(5.31,9.33),P<0.00001],食欲显著改善[OR=10.85,95%CI(8.09,14.56),P<0.00001],卡氏功能状态(KPS)评分显著升高[OR=6.36,95%CI(4.74,8.54),P<0.00001]。醋酸甲地孕酮治疗晚期肿瘤487例患者共发生54例次(11.09%)不良反应,最常见的为四肢末端可凹性水肿(3.90%)。结论醋酸甲地孕酮可增加晚期肿瘤患者的体质量,改善其食欲,提高生活质量,且安全性较好。
Objective To systematically review the efficacy and safety of megestrol acetate for improving the quality of life in patients with advanced cancer.Methods Studies related to megestrol acetate in the treatment of advanced cancer and anorexia-cachexia syndrome published from 2012 to 2022 in the PubMed,The Cochrane Library,ClinicalTrials.gov,Web of Science,Embase,CNKI,CBM and WanFang databases were searched.The studies were screened according to the inclusion and exclusion criteria,and the Cochrane tool,and the Transparent Reporting of Evaluations with Nonrandomized Designs(TREND)were used to assess the quality and bias risk of randomized controlled trials(RCTs)and quasi-experimental studies(QES).The RevMan 5.3 software was used for Meta-analysis.Results A total of 24 studies were included,involving 1815 patients,including five RCTs and nineteen QES.Meta-analysis results showed that compared with those in the group receiving only conventional treatment,the body mass significantly increased[OR=7.04,95%CI(5.31,9.33),P<0.00001],the appetite significantly improved[OR=10.85,95%CI(8.09,14.56),P<0.00001],and the Karnofsky performance score(KPS)score significantly improved[OR=6.36,95%CI(4.74,8.54),P<0.00001]in the group receiving conventional treatment+megestrol acetate.Megestrol acetate for the treatment of advanced cancer involved 487 patients,with 54 cases(11.09%)of adverse reactions,the most common being concave edema of the extremities(3.90%).Conclusion Megestrol acetate can increase body mass,improve appetite,and quality of life in patients with advanced cancer,with good safety.
作者
杨丽萍
张照华
邓翠婷
李明洙
YANG Liping;ZHANG Zhaohua;DENG Cuiting;LI Mingzhu(Zhujiang Hospital of Southern Medical University,Guangzhou,Guangdong,China 510000;Gaozhou People's Hospital,Maoming,Guangdong,China 525200)
出处
《中国药业》
CAS
2023年第23期126-132,共7页
China Pharmaceuticals
