| 吴 鹏,赵玉梅,陈冬梅.奈达铂与顺铂联合同期调强放疗治疗局部晚期鼻咽癌随机对照试验的Meta分析[J].肿瘤学杂志,2019,25(2):107-115. |
| 奈达铂与顺铂联合同期调强放疗治疗局部晚期鼻咽癌随机对照试验的Meta分析 |
| Nedaplatin or Cisplatin Combined with Simultaneous Intensity-modulated Radiation Therapy for Locally Advanced Nasopharyngeal Carcinoma：A Meta-analysis of Randomised Controlled Trials |
| 投稿时间：2018-09-13 |
| DOI：10.11735/j.issn.1671-170X.2019.02.B007 |
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| 中文关键词: 鼻咽肿瘤 奈达铂 顺铂 调强放疗 Meta分析 |
| 英文关键词:nasopharyngeal carcinoma nedaplatin cisplatin intensity-modulated radiation therapy meta-analysis |
| 基金项目:国家自然科学基金青年基金项目（81201784） |
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| 中文摘要: |
| 摘 要：［目的］ 系统评价奈达铂与顺铂联合同期调强放疗(intensity modulated radiation therapy，IMRT)治疗局部晚期鼻咽癌(nasopharyngeal carcinoma，NPC)的疗效与安全性。［方法］ 计算机检索PubMed、EMBASE、The Cochrane Library、CNKI、CBM、VIP和万方等数据库，检索时间截至2018年5月，收集对比奈达铂与顺铂联合同期IMRT治疗局部晚期NPC的疗效与安全性的研究，由2名研究员分别对纳入的研究进行数据提取和质量评价，最后采用Cochrane协作网提供的Revman 5.3软件进行Meta分析。［结果］ 共纳入14项临床随机对照试验(randomised controlled trial，RCT)，共计1709例患者。Meta分析结果显示：对于局部晚期NPC，两组2年总生存率、无进展生存率、无远处转移生存率及局控率相当，并且两组的总缓解率、鼻咽原发灶及颈部转移灶缓解率差异均无统计学意义。同步奈达铂化疗降低了胃肠道反应(RR=0.44，95%CI：0.30~0.64，P<0.0001)及肾毒性(RR=0.28，95%CI：0.17~0.47，P<0.00001)的发生率，但增加了血小板减少症(RR=1.36，95%CI：1.01~1.85，P=0.04)的发生风险。［结论］ 对于局部晚期NPC，同步奈达铂与同步顺铂联合同期IMRT在长期、近期疗效上相当，同步奈达铂能够减少胃肠道反应、肾毒性的发生，但同时增加了发生血小板减少症的风险。从疗效及安全性方面考虑，奈达铂能够替代顺铂联合同期IMRT治疗局部晚期NPC。 |
| 英文摘要: |
| Abstract：［Objective］ To evaluate the effect and safety of nedaplatin versus cisplatin combined simultaneous intensity-modulated radiation therapy(IMRT) for locally advanced nasopharyngeal carcinoma(NPC).［Methods］ The comparative studies on nedaplatin and cisplatin combined with simultaneous IMRT for locally advanced NPC were retrieved from PubMed，EMBASE，theCochrane Library，CNKI，CBM，VIP and Wanfang Data. All data were acquired from their establishment to May 2018. Literature screening according to data extraction and quality assessment was completed by two reviewers independently. Meta-analysis was carried out by RevMan 5.3 software offered by Cochrane network.［Results］ A total of 14 RCTs involving 1709 patients were finally included. The results of Meta-analysis showed：there was no significant difference between nedaplatin and cisplatin group regarding 2-year overall survive，progression-free survival，distant metastasis-free survival and locorelapse-free survival，the same with short-term effects. Meanwhile，nedaplatin group could significantly reduce the risk of gastrointestinal(RR=0.44，95%CI：0.30~0.64，P<0.0001) and renal function impairment(RR=0.28，95%CI：0.17~0.47，P<0.00001)，but it was associated with higher risk of thrombocytopenia(RR=1.36，95%CI：1.01~1.85，P=0.04). ［Conclusion］ For locally advanced NPC，compared with cisplatin，concurrent chemothrapy with nedaplatin can bring comparable long-term and short-term effects，but it can reduce the risk of gastrointestinal and renal function impairment，at the same time increase the risk of thrombocytopenia. Nedaplatin combined simultaneous IMRT could be an alternative for locally advanced NPC. |
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