紫杉醇治疗上皮性卵巢癌密集型疗法的系统评价_《中国循证医学杂志》

作者：

1. 四川大学华西第二医院妇产科（成都 610041）； 2. 四川大学华西医院循证医学与临床流行病学教研室（成都 610041）;

关键词：

紫杉醇密集型疗法传统疗法卵巢癌系统评价

DOI：

10.7507/1672-2531.20090241

视频：

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摘要 全文 图表 视频 参考文献 施引文献 补充材料

目的　系统评价紫杉醇联合铂类治疗上皮性卵巢癌密集型疗法的临床疗效和安全性。
方法　计算机检索Cochrane 临床对照试验资料库（2008 年第2 期）、MEDLINE（1980 年1 月～ 2008 年6 月）、EMbase（1984 ～ 2008年6 月）、中国生物医学文献数据库（1980 年1 月～ 2008 年6 月）、CNKI（1980 ～ 2008 年6 月）等，收集有关紫杉醇治疗上皮性卵巢癌密集型疗法与传统疗法的随机对照试验（RCT）。由两名研究者共同完成文献筛选、资料提取并进行质量评价后，采用RevMan 5.0 软件进行Meta 分析。
结果　最终纳入6 篇文献，其中外文3 篇、中文3 篇，包括572 例患者。Meta 分析结果显示：① 疗效评估：密集型疗法与传统疗法在治疗有效率［RR=1.06，95%CI（0.94，1.20）］、中位生存期、生存率、中位无进展生存时间、中位进展时间方面差异均无统计学意义。② 毒副反应：密集型疗法在降低Ⅲ度以上中性粒细胞减少的发生率［RR=0.49，95%CI（0.35，0.69），P lt;0.000 1］以及Ⅲ度以上神经毒性反应［RR=0.43，95%CI（0.24，0.78），P=0.006］上有明显优势。面色潮红、Ⅲ度以上的呕吐、贫血、白细胞减少、Ⅲ度以上血小板减少以及脱发等方面与传统疗法相比，其差异无统计学意义。
结论　紫杉醇密集型疗法和传统疗法比较，治疗效果相似，毒副反应基本相近，但能明显降低Ⅲ度以上中性粒细胞减少及Ⅲ度以上神经毒性反应的发生率。因此，密集型疗法是传统疗法良好的替代治疗方案。

引用本文： 程萌,谢聪,王丹青,尹如铁,康德英. 紫杉醇治疗上皮性卵巢癌密集型疗法的系统评价. 中国循证医学杂志, 2009, 09(12): 1328-1335. doi: 10.7507/1672-2531.20090241 复制

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12.	朱丽荣, 廖秦平, 温宏武, 等. 紫杉醇治疗卵巢癌周疗与月疗的临床对比研究. 中国医刊, 2004, 39(4): 32-37.
13.	沈铿, 李孟达, 丰有吉, 等. 代表中国妇科肿瘤学组. 泰素周疗和三周疗法作为卵巢癌一线化疗的多中心对照研究. 中华医学杂志, 2005, 8(30): 2099-2103.
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1. Wang TH, Wang HS, Soong YK. Paclitaxel-induced cell death: where the cell cycle and apoptosis come together. Cancer, 2000, 88(11): 2619-2628.
2. Kuh HJ, Jang SH, Wientjes MG, et al. Computational model of intracellular pharmacokinetics of paclitaxel. J Pharmacol Exp Ther, 2000, 293(3): 761-770.
3. 陆红霞. 紫杉醇剂型、临床用药方式及联合用药的研究进展. 国外医学药学分册, 2005, 2(32): 73-77。.
4. Mori T, Kinoshita Y, Watanabe A, et al. Retention of paclitaxel in cancer cells for 1 week in vivo and in vitro. Cancer Chemother Pharmacol, 2006, 58(5): 665-672.
5. Choy H, Akerley W, Safran H, et al. Phase I trial of outpatient weekly paclitaxel and concurrent radiation therapy for advanced non-smallcell lung cancer. J Clin Oncol, 1994, 12(12): 2682-2686.
6. Sehouli J, Stengel D, Mustea A, et al. Weekly paclitaxel and carboplatin (PC-W) for patients with primary advanced ovarian cancer: results of a multicenter phase-II study of the NOGGO. Cancer Chemother Pharmacol, 2008, 61(2): 243-250.
7. Higgins JLT, Green S. The Cochrane collaboration. Cochrane Handbook for Systematic Reviews of Interventions 4.2.6. The Cochrane Library, 2006.
8. Rosenberg P, Andersson H, Boman K, et al. Randomized trial of single agent paclitaxel given weekly versus every three weeks and with peroral versus intravenous steroid premedication to patients with ovarian cancer previously treated with platinum. Acta Oncol, 2002, 41(5): 418- 424.
9. Wu CH, Yang CH, Lee JN, et al. Weekly and monthly regimens of paclitaxel and carboplatin in the management of advanced ovarian cancer. A preliminary report on side effects. Int J Gynecol Cancer, 2001, 11(4): 295-299.
10. de Jongh FE, de Wit R, Verweij J, et al. Dose-dense cisplatin/paclitaxel. a well-tolerated and highly effective chemotherapeutic regimen in patients with advanced ovarian cancer. Eur J Cancer, 2002, 38(15): 2005-2013.
11. 段微, 路虹, 范逢晓. 国产紫杉醇治疗上皮性卵巢癌周疗方案与月疗方案的比较. 中国肿瘤临床与康复, 2006, 13(1): 73-74.
12. 朱丽荣, 廖秦平, 温宏武, 等. 紫杉醇治疗卵巢癌周疗与月疗的临床对比研究. 中国医刊, 2004, 39(4): 32-37.
13. 沈铿, 李孟达, 丰有吉, 等. 代表中国妇科肿瘤学组. 泰素周疗和三周疗法作为卵巢癌一线化疗的多中心对照研究. 中华医学杂志, 2005, 8(30): 2099-2103.
14. Gianni L, Keens CM, Gianni A, et al. Non-linear pharmacokinetics and metabolism of paclitaxel and its pharmacokinetic/ pharmacodynamic relationships in humans. J Clin Oncol, 1995, 13: 180-190.
15. Kurihara M, Sakamoto H, Ohta Y, et al. Patient compliance and the quality of life are well maintained in weekly paclitaxel and carboplatin therapy for advanced gynecologic cancers in Japanese women. Gan To Kagaku Ryoho, 2001, 28: 55-61.

《中国循证医学杂志》

紫杉醇治疗上皮性卵巢癌密集型疗法的系统评价

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《中国循证医学杂志》

紫杉醇治疗上皮性卵巢癌密集型疗法的系统评价

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