GnRH拮抗剂地加瑞克治疗前列腺癌的安全性及有效性的Meta分析

发布时间：2018-02-23 17:22

本文关键词： 前列腺癌地加瑞克 Meta分析　出处：《兰州大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:系统的探讨促性腺激素释放激素(GnRH)受体拮抗剂地加瑞克治疗前列腺癌的安全性、有效性及不同剂量方案之间的疗效评价。方法:通过计算机检索Pub Med、EMBASE、the Cochrane Library、Web of Science等数据库中的相关文献,系统地搜索识别随机对照试验与促性腺激素释放激素(GnRH)受体拮抗剂地加瑞克(240/80mg vs 240/160mg),促性腺激素释放激素(GnRH)受体激动剂戈舍瑞林、亮丙瑞林等对治疗前列腺癌的疗效比较。两个独立的研究者进行文献筛选,筛选评估偏差的风险,然后根据预先制定的纳入与排除标准筛选和纳入,提取相关数据。分析相关数据使用Manager 5.2软件。结果:包含6个随机对照实验,涉及1204个患者的7篇文献是符合纳入标准的。系统的分析相关数据表明,相比较240/80 mg(初始剂量240mg;维持剂量80mg)地加瑞克组,用240/160 mg(初始剂量240mg;维持剂量160mg)地加瑞克组治疗前列腺癌是更有效的,且不良反应率更低。与戈舍瑞林相比较,地加瑞克能够显著的降低国际前列腺症状评分(IPSS)[标准差(SMD)=-0.32,95%CI:-0.51~-0.12,P=0.02],引起的不良反应发生率更低(SMD=-0.28,95%CI:-0.48~-0.07,P=0.008)。地加瑞克抑制睾酮及前列腺特异性抗原水平明显优于亮丙瑞林。结论:针对晚期前列腺癌的治疗,地加瑞克是一个有效的选择。240/160 mg地加瑞克组治疗方案优于240/80 mg地加瑞克组治疗方案。目前迫切的需要制定更严格的随即对照实验来进一步证实地加瑞克的功效。
[Abstract]:Objective: to investigate the safety of the gonadotropin releasing hormone (GnRH) receptor antagonist Digarek in the treatment of prostate cancer. Methods: a computer search was carried out to find the relevant documents in the database of the Cochrane Library of Science, including Pub Medus, the Cochrane Library of Science, and so on. Systematic search and identification of randomized controlled trials and gonadotropin-releasing hormone (GnRH) receptor antagonist, Digarex 240 / 80 mg vs 240 / 160 mg / g, gonadotropin releasing hormone (GnRH) receptor agonist, GnRH, were performed. Two independent researchers screened the literature to assess the risk of bias, and then screened and included according to pre-established inclusion and exclusion criteria. Manager 5.2 software was used to analyze the relevant data. Results: seven articles including 6 randomized controlled trials involving 1204 patients met the inclusion criteria. A systematic analysis of the relevant data showed that, Compared with 240/80 mg (initial dose 240 mg; maintenance dose 80 mg), the treatment of prostate cancer with 240/160 mg (initial dose 240 mg; maintenance dose 160 mg) was more effective and the adverse reaction rate was lower. Digarek was able to significantly reduce the international prostate symptom score (IPSSS) [standard deviation: SMD-0.32O95 CI-0.51U -0.12P0. 02], and the incidence of adverse reactions was lower than that of SMD-0.2895CI-0.48CI-0.07P0.008.The inhibition of testosterone and prostate specific antigen levels by Diggaric was significantly higher than that of Leurelin. For advanced prostate cancer, Diggaric is an effective choice. 240 / 160mg group is better than 240/80 mg group. There is an urgent need to develop a more rigorous randomized controlled trial to further verify the efficacy of Garek.
【学位授予单位】：兰州大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R737.25

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