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[摘要]
目的 评价脂质体多柔比星(脂质体阿霉素)治疗恶性肿瘤的临床疗效及安全性。方法 计算机检索中国学术文献总库(CNKI)、万方数字化期刊库、中国生物医学文献数据库(CBM)、维普中文科技期刊数据库(VIP),PubMed数据库、Embase数据库和Cochrane Library数据库,脂质体多柔比星治疗恶性肿瘤的中英文随机对照试验,检索年限从建库至2017年1月。采用RevMan 5.3软件对各效应指标进行Meta分析。结果 纳入23篇RCT文献,计5 546名恶性肿瘤患者。Meta分析结果显示:治疗前后临床疗效I2=63%、OR=1.14[1.02,1.27],P=0.002;两组化疗后心脏毒性不良事件I2=0%,OR=0.18[0.10,0.33],P<0.000 01;脱发不良事件I2=77%,OR=0.24[0.17,0.35],P<0.000 01;神经毒性不良事件I2=46%,OR=0.65[0.42,0.99],P=0.05。结论 脂质体多柔比星治疗恶性肿瘤的临床疗效优于其他化疗方案,且毒副作用低,尤其在改善心脏毒性、脱发等不良事件方面明显优于其他化疗方案。
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[Abstract]
Objective To evaluate the clinical efficacy and safety of liposomal doxorubicin in the treatment of cancer. Methods The randomized controlled trials of liposomal doxorubicin in treatment of cancer were searched from Chinese academic literature database (CNKI), Wanfang digital journals, Chinese biomedical literature database (CBM), Chinese scientific journal database (VIP), PubMed database, Embase database and The Cochrane Library database. Data were collected from establishment of the database to January 2017 and the each index was analyzed by Meta-analysis with RevMan 5.3 software. Results A total of 5546 patients with malignant tumors were included in the RCT literature of the 23 articles. The Meta analysis results showed that the analysis on clinical curative effect before and after treatment:I2=63%, OR=1.14[1.02, 1.27], P=0.002; the analysis on safety evaluation of Meta of two groups of cardiac toxicity adverse events:I2=0%, OR=0.18[0.10, 0.33], P<0.00001; I2=77%, OR=0.24[0.17, 0.35]; the analysis on alopecia adverse events:P<0.000 01; I2=46% OR=0.65[0.42, 0.99], the ananlysis on neurotoxic adverse events:P=0.05. Conclusion The clinical efficacy of liposomal doxorubicin in the treatment of malignant tumors is better than other chemotherapy regimens, with low side effects, and is especially significantly better than other chemotherapy regimens in the improvement of cardiac toxicity, neurotoxicity, alopecia and other adverse events.
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