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尼妥珠单抗联合放化疗治疗晚期鼻咽癌疗效和安全性的Meta分析

Nimotuzumab Plus Radiotherapy Combined with Chemotherapy in the Treatment of Advanced Nasopharyngeal Cancer: a Meta analysis

DOI：

中文关键词: 尼妥珠单抗放化疗晚期鼻咽癌 Meta分析

英文关键词:Nimotuzumab Radiotherapy combined with chemotherapy Advanced nasopharyngeal cancer Meta analysis

基金项目:

作者	单位
王冰¹ 薛变琴² 刘伟² 刘芳芳³	山西省肿瘤医院 1.药学部；2.普外二科；3.药理研究室太原030013

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中文摘要:

摘要目的：采用Meta分析方法评价尼妥珠单抗联合放化疗治疗晚期鼻咽癌的疗效和安全性。方法：计算机检索CNKI、WanFang Data、VIP、PubMed、Embase和The Cochrane Library数据库，全面收集尼妥珠单抗联合放化疗（试验组）对比放化疗（对照组）治疗晚期鼻咽癌的随机对照试验（RCTs），检索时限均为建库至2017年9月20日。对纳入研究进行偏倚风险评价和资料提取后，使用RevMan 5.3软件进行Meta分析。结果：共纳入13个RCTs，包括839例患者。Meta分析结果显示，试验组的肿瘤完全缓解率[RR=1.37，95%CI（1.14，1.66），P<0.05]、总有效率[RR=1.19，95%CI（1.04，1.35），P<0.05]、肿瘤1年局部控制率[RR=1.08，95%CI（1.01，1.17），P<0.05]均高于对照组；两组患者白细胞下降 [RR=0.80，95%CI（0.56，1.15），P>0.05]、血小板下降 [RR=0.75，95%CI（0.53，1.07），P>0.05]、恶心、呕吐[RR=0.86，95%CI（0.47，1.57），P>0.05]、肝功能异常 [RR=0.85，95%CI（0.52，1.39），P>0.05]等不良反应发生率比较，差异均无统计学意义。结论：尼妥珠单抗联合放化疗治疗晚期鼻咽癌的疗效优于放化疗治疗，且安全性相当。但由于纳入研究质量较低，结论还需设计完善的大规模临床试验进一步验证。

英文摘要:

ABSTRACT Objective:To evaluate the therapeutic efficacy and safety of nimotuzumab plus radiotherapy combined with chemotherapy in the treatment of advanced nasopharyngeal cancer. Methods:Randomized controlled trials (RCTs) on the treatment of advanced nasopharyngeal cancer with nimotuzumab plus radiotherapy combined with chemotherapy (treatment group) vs. radiotherapy combined with chemotherapy (control group) were searched in PubMed, Embase, The Cochrane Library, CNKI, WanFang Data and VIP database from inception to September 20th, 2017. Conduct Meta analysis with extracted data from qualified included studies using the RevMan 5.3 software.Results: A total of 13 RCTs were included, including 839 patients. The results of Meta analysis showed that compared with the control group, the treatment group significantly increased the complete response rate [RR=1.37, 95%CI(1.14, 1.66), P<0.05], overall response rate [RR=1.19, 95%CI(1.04, 1.35), P<0.05], 1 year local control rate of tumor [RR=1.08, 95%CI(1.01, 1.17), P<0.05]. Meanwhile, compared with the control group, the treatment group didn’t decrease the incidence rate of leukocyte decrease [RR=0.80, 95%CI(0.56, 1.15), P>0.05], the incidence rate of platelet decrease [RR=0.75, 95%CI(0.53, 1.07), P>0.05], the incidence rate of nausea and vomiting [RR=0.86, 95%CI(0.47, 1.57), P>0.05], the incidence rate of liver function abnormalities [RR=0.85, 95%CI(0.52, 1.39), P>0.05]. 〖WTHZ〗Conclusion:〖WTBZ〗Therapeutic efficacy of nimotuzumab plus radiotherapy combined with chemotherapy was superior to the control in the treatment of advanced nasopharyngeal cancer, while the safety concerning the two groups were equivalent. Owing to the lower qualities of the included studies, the conclusion requireed further confirmation from well designed and large scale clinical trials.

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