吉林大学学报(医学版) ›› 2017, Vol. 43 ›› Issue (06): 1171-1176.doi: 10.13481/j.1671-587x.20170619

• 临床研究 • 上一篇    下一篇

新辅助化疗联合卡培他滨治疗乳腺癌疗效和不良反应的Meta分析

牛会坤, 曲洋明, 李美奇, 李璐, 吕欣, 宋媛媛, 高春时, 李波   

  1. 吉林大学公共卫生学院流行病与卫生统计学教研室, 吉林长春 130021
  • 收稿日期:2017-06-08 出版日期:2017-11-28 发布日期:2017-12-01
  • 通讯作者: 李波,教授,硕士研究生导师(Tel:0431-85619451,E-mail:li_bo@jlu.edu.cn) E-mail:li_bo@jlu.edu.cn
  • 作者简介:牛会坤(1992-),女,河北省石家庄市人,在读医学硕士,主要从事慢性病流行病学方面的研究。
  • 基金资助:
    吉林省科技厅科研基金资助课题(20130201002ZY)

Meta-analysis on efficacy and adverse effects of neoadjuvant chemotherapy combined with capecitabine in treatment of breast cancer

NIU Huikun, QU Yangming, LI Meiqi, LI Lu, LYU Xin, SONG Yuanyuan, GAO Chunshi, LI Bo   

  1. Department of Epidemiology and Health Statistics, School of Public Health, Jilin University, Changchun 130021, China
  • Received:2017-06-08 Online:2017-11-28 Published:2017-12-01

摘要: 目的:探讨在蒽环类药物治疗基础上采用多西他赛联合卡培他滨治疗乳腺癌患者的疗效和不良反应,为卡培他滨的临床应用提供循证医学证据。方法:计算机检索PubMed、EMBase、CNKI、VIP和万方数据库,纳入在蒽环类药物治疗基础上使用多西他赛联合卡培他滨与单用多西他赛对比治疗乳腺癌的随机对照试验。按改良Jadad量表评价所纳入研究的质量,提取有效数据后,采用RevMan5.3软件对2种方法治疗后患者的完全病理缓解率(pCR)、无复发生存率(RFS)、无病生存率(DFS)和安全性进行Meta分析。结果:共纳入10篇文献,包括12 012例患者。Meta分析,在蒽环类药物治疗基础上使用多西他赛联合卡培他滨与单用多西他赛时患者的pCR (RR=1.04,95% CI:0.91~1.18,P=0.59)、RFS (RR=0.86,95% CI:0.71~1.03,P=0.10)和DFS (RR=0.98,95% CI:0.86~1.11,P=0.71)比较差异无统计学意义。临床安全性分析,多西他赛联合卡培他滨更易引起手足综合征(OR=7.13,95% CI:4.76~10.69,P<0.001)和口腔炎(OR=1.93,95% CI:1.10~3.40,P=0.02)等不良反应。结论:在蒽环类药物治疗基础上,多西他赛联合卡培他滨与单用多西他赛治疗乳腺癌的疗效相似,且前者的手足综合征和口腔炎发生率高于后者。

关键词: 乳腺肿瘤, Meta分析, 卡培他滨, 多西他赛

Abstract: Objective:To explore the efficacy and adverse effects of docetaxel combined with capecitabine on the basis of anthracycline in the treatment of breast cancer patient on the basis of anthracycline, and to provide evidence-based medicine evidence for the clinical application of capecitabine. Methods:PubMed, EMBase, CNKI, VIP and Wanfang database were used to search the randomized controlled trials in which the breast cancer patients were treated by docetaxel combined with capecitabine and docetaxel alone. The qualities of the included studies were assessed by the modified Jadad scale. The effective data were extracted and the pathologic complete remission (pCR), recurrence-free survival (RFS), disease-free survival (DFS) and safety were evaluated by RevMan 5.3 software. Results:A total of 10 articles were included, including 12 012 patients. The Meta-analysis results showed that there were no statistically significant differences in pCR (RR=1.04, 95%CI:0.91-1.18, P=0.59),RFS(RR=0.86, 95%CI:0.71-1.03,P=0.10) and DFS(RR=0.98, 95%CI:0.86-1.11,P=0.71) between docetaxel combined with capecitabine and docetaxel alone. The clinical safety analysis results showed that the patients treated with docetaxel combined with capecitabine were susceptible to hand-foot syndrome (OR=7.13, 95%CI:4.76-10.69, P<0.001) and stomatitis (OR=1.93, 95%CI:1.10-3.40, P=0.02). Conclusion:On the basis of anthracycline treatment, the efficacies of docetaxel combined with capecitabine and docetaxel alone in the treatment of the breast cancer patients are similar. The former is more likely to cause the hand-foot syndrome and stomatitis.

Key words: breast neoplasms, Meta-analysis, docetaxel, capecitabine

中图分类号: 

  • R969.4