氟维司群与芳香化酶抑制剂治疗激素受体阳性晚期乳腺癌的疗效比较:Meta分析

发布时间：2019-05-17 03:34

【摘要】：目的 :评价氟维司群与芳香化酶抑制剂(aromatase inhibitor,AI)治疗激素受体阳性晚期乳腺癌的疗效和安全性。方法:计算机检索Pub Med、Cochrane Library、相关期刊论文和万方数据库,检索时间从建库起至2016年12月,收集氟维司群与AI治疗激素受体阳性晚期乳腺癌的临床随机对照试验。由2名研究人员各自按文献选择标准筛选文献,并提取数据。应用Rev Man 5.3软件进行Meta分析。结果:共纳入8项随机对照试验,共计3 776例患者。Meta分析结果显示,氟维司群与AI治疗激素受体阳性晚期乳腺癌的疾病进展时间(time to progression,TTP)(风险比为0.94,95%可信区间:0.87~1.00;P=0.07)、治疗失败时间(time to treatment failure,TTF)(风险比为0.97,95%可信区间:0.88~1.06;P=0.46)和客观缓解率(objective response rate,ORR)(比值比为1.11,95%可信区间:0.92~1.34;P=0.28)以及因不良反应而中断治疗(比值比为1.10,95%可信区间:0.70~1.73;P=0.68)、无力(比值比为0.83,95%可信区间:0.66~1.06;P=0.13)和恶心(比值比为1.11,95%可信区间:0.89~1.38;P=0.35)等不良反应的差异均无统计学意义,但是氟维司群能够提高临床获益(比值比为1.17,95%可信区间:1.02~1.33;P=0.02)。亚组分析中,氟维司群一线治疗的TTP(风险比为0.75,95%可信区间:0.62~0.91;P=0.003)以及500 mg氟维司群高剂量治疗的TTP(风险比为0.89,95%可信区间:0.80~0.99;P=0.03)均可使患者获益。结论:氟维司群与AI治疗激素受体阳性晚期乳腺癌的TTP、TTF、ORR以及因不良反应而中断治疗的发生率相似;但是氟维司群能够显著提高患者的临床获益。此外,氟维司群一线治疗以及500 mg氟维司群高剂量治疗均可使患者的预后得到改善。
[Abstract]:Objective: to evaluate the efficacy and safety of fluoride group and aromase inhibitor (aromatase inhibitor,AI) in the treatment of hormone receptor positive advanced breast cancer. Methods: the full-text database and Wanfang database of Pub Med,Cochrane Library, Chinese journals were searched by computer. From the establishment of the database to December 2016, the clinical randomized controlled trials of fluvidone group and AI in the treatment of advanced breast cancer with positive hormone receptor were collected. The literature was screened by two researchers according to the criteria of literature selection, and the data were extracted. Meta analysis was carried out with Rev Man 5.3 software. Results: a total of 3 776 patients were enrolled in 8 randomized controlled trials. Meta-analysis showed that the disease progression time of flunulide group and AI in the treatment of hormone receptor positive advanced breast cancer was (time to progression,. The risk ratio of TTP) (was 0.94, 95% confidence interval: 0.87 鈮，

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