国际肿瘤学杂志

国际肿瘤学杂志 ›› 2015, Vol. 42 ›› Issue (5): 336-341.doi: 10.3760/cma.j.issn.1673422X.2015.05.005

• 论著 • 上一篇    下一篇

重组人p53腺病毒注射液联合顺铂治疗恶性胸腔积液疗效及安全性的Meta分析

  

  1. 安徽医科大学第一附属医院肿瘤内科
  • 出版日期:2015-05-08 发布日期:2015-05-12
  • 通讯作者: 孙国平 sungp@ahmu.edu.cn
  • 基金资助:

    国家自然科学基金（81272739）

Efficacy and safety of recombinant human Adp53 injection combined with cisplatin in treating malignant pleural effusion: a Metaanalysis

  1. Department of Oncology, First Affilia ted Hospital of Anhui Medical University
  • Online:2015-05-08 Published:2015-05-12
  • Contact: Sun Guoping sungp@ahmu.edu.cn

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摘要： 目的 运用Meta分析的方法评价重组人p53腺病毒（rAdp53）注射液联合顺铂治疗恶性胸腔积液的疗效及安全性。方法 应用Cochrane Library、Pubmed、Embase、中国生物医学文献数据库、中国期刊全文数据库、万方医药期刊全文数据库及维普中文科技期刊全文数据库，全面收集有关rAdp53联合顺铂与单药顺铂治疗恶性胸腔积液的随机对照研究（RCT）。用RevMan5.2软件对数据进行Meta分析。结果 本研究共纳入10篇RCT，总计538例患者。Meta分析结果显示，rAdp53联合顺铂组与单药顺铂组相比，胸腔积液总缓解率前者高于后者（RR=1.67，95%CI为0.90～2.01；Z=5.51，P=0.000 01）；Kamofsky评分改善率前者高于后者（RR=1.76，95%CI为1.45～2.14；Z=5.69，P<0.000 01）；发热发生率前者高于后者（RR=3.10，95%CI为2.25～4.27；Z=6.94，P<0.000 01）；两组胸痛发生率比较差异无统计学意义（RR=0.99，95%CI=0.5～1.96，Z=0.04，P=0.97）；消化道反应发生率比较差异无统计学意义（RR=1.16，95%CI=0.90～1.50；Z=1.13，P=0.26），骨髓抑制反应发生率比较差异无统计学意义（RR=1.09，95%CI=0.81～1.47；Z=0.59，P=0.55）。结论 现有研究表明，rAdp53联合顺铂治疗恶性胸腔积液的疗效优于单药顺铂，发热均为自限性，安全性好，值得晚期恶性肿瘤伴胸腔积液患者治疗的临床推广。

关键词: 胸腔积液, 恶性/顺铂/Meta分析/重组人p53腺病毒

Abstract: ObjectiveTo assess the efficacy and safety of recombinant human Adp53 (rAdp53) injection combined with cisplatin in treating malignant pleural effusion by conducting a Metaanalysis. MethodsA comprehensive collection of randomized controlled studies (RCTs) of rAdp53 combined with cisplatin versus single cisplatin in the treatment of malignant pleural effusion was retrieved form Cochrane Library, Pubmed, EMBase, CBM, CNKI, Wanfang and VIP databases. Metaanalysis was conducted by RevMan 5.2 software. ResultsTen RCTs involving 538 patients were identified in the study. The Metaanalysis results showed that rAdp53 combined with cisplatin group had a higher hydrothorax total remission rate than single cisplatin group (RR=1.67, 95%CI: 0.902.01; Z=5.51, P=0.000 01). The PS score in rAdp53 combined with cisplatin group was better than that in single cisplatin group (RR=1.76, 95%CI: 1.452.14; Z=5.69, P<0.000 01). The incidence rate of adverse reaction of heating in the former was higher than that in the latter (RR=3.10, 95%CI: 2.254.27; Z=6.94, P<0.000 01). There were no significant differences in adverse reactions of chest pain (RR=0.99, 95%CI: 0.501.96; Z=0.04, P=0.97), gastrointestinal reaction (RR=1.16, 95%CI: 0.901.50; Z=1.13, P=0.26) and marrow suppression (RR=1.09, 95%CI: 0.811.47; Z=0.59, P=0.55) between the two groups. ConclusionrAdp53 combined with cisplatin therapy for the treatment of malignant pleural effusion is superior to single cisplatin therapy. Mean while, fever is selflimited, and the safety is identified. It is worthy for promotion of rAdp53 injection combined with cisplatin in clinical treatment of advanced malignant pleural effusion.