A systematic analysis in efficacy and safety of nimotuzumab combined with concurrent chemoradiotherapy in treatment of advanced esophageal cancer
-
摘要:目的 分析尼妥珠单抗注射液联合同步放化疗治疗晚期食管癌的临床疗效。方法 检索知网、万方、维普、中国生物医学（CBM）、PubMed、Cochrane Library、Wiley Online Library和谷歌学术等数据库，检索尼妥珠单抗联合同步放化疗（试验组）与同步放化疗（对照组）治疗晚期食管癌的随机对照试验（RCT）。应用RevMan5.3软件分析组间客观缓解率（ORR）、疾病控制率（DCR）以及药物的相关不良反应发生率的差异。结果 最终纳入9项研究，其中有8项为中文研究，1项为外文研究。Meta分析结果显示，试验组患者ORR、DCR显著改善且不会增高不良反应的发生率。结论 尼妥珠单抗注射液联合同步放化疗的疗效及用药安全性值得肯定，治疗过程中可能出现皮疹及血压变化，但概率较低、程度较轻。Abstract:Objective To analyze the clinical effect of nitorzumab injection combined with concurrent chemoradiotherapy in the treatment of advanced esophageal cancer.Methods The databases such as CNKI, Wanfang, VIP, China Biology Medicine (CBM), PubMed, Cochrane Library, Wiley Online Library and Google Academic were searched. The randomized controlled trials (RCT) of nituozumab combined with concurrent chemoradiotherapy (experimental group) and concurrent chemoradiotherapy (control group) were searched. The between-group differences of objective remission rate (ORR), disease control rate (DCR) and drug-related adverse reactions were analyzed by RevMan5.3 software.Results Totally 9 studies were included, in which 8 studies were Chinese literatures and one study was foreign language literature. Meta-analysis showed that the ORR and DCR of the experimental group significantly improved and the incidence of adverse reactions was not increased.Conclusion Efficacy and safety of nituozumab injection combined with concurrent chemoradiotherapy are reliable and definite. Rash and change of blood pressure may appear in the course of treatment, but the probability and the degree are relative low.
-
Keywords:
- esophageal cancer /
- nimotuzumab /
- concurrent chemoradiotherapy /
- systematic analysis
-
-
表 1 纳入文献的基本特征
文献 例数 年龄/岁 干预方式 结局 Jadad评分/分 试验组 对照组 试验组 对照组 RAMOS-SUZARTE M等(2012) 33 30 18~75 尼妥珠单抗200 mg联合放化疗(PF方案: DDP+5-FU) 放化疗(PF方案: DDP+5-FU) a b f gh i j k l 3 傅国林(2017) 40 40 31~76 尼妥珠单抗200 mg联合放化疗(TP方案: DXT+DDP) 放化疗(TP方案: DXT+DDP) a b fg i k 4 侯小霞等(2019) 39 39 18~75 尼妥珠单抗200 mg联合放化疗(TP方案: PXT+DDP) 放化疗(TP方案: PXT+DDP) a b f gh i j 3 刘慧娟等(2015) 46 46 45~78 NIM(剂量未标明)联合放化疗(TP方案: DXT+DDP) 放化疗(TP方案: DXT+DDP) a f g i 3 周云(2017) 20 20 47~64 尼妥珠单抗200 mg联合放化疗(PF方案: LBP+5-FU) 放化疗(PF方案: LBP+5-FU) a b f g i 3 张云霞等(2018) 20 20 34~70 尼妥珠单抗200 mg联合放化疗(TP方案: PXT + DDP) 放化疗(PF方案: DDP+5-FU) a b h l m 3 李明耀等(2018) 40 40 48~64 尼妥珠单抗200 mg联合放化疗(TP方案: DXT+DDP) 放化疗(TP方案: DXT+DDP) a b c d f i 3 陈玉兰等(2016) 32 32 39~68 尼妥珠单抗100 mg联合放化疗(P方案: NDP) 放化疗(P方案: NDP) a b c d e f h i k 3 黄丹丹等(2012) 22 29 35~70 尼妥珠单抗200 mg联合放化疗(TP方案: DXT+DDP) 放化疗(TP方案: DXT+DDP) a b c f g i 3 DDP: 顺铂; 5-FU: 5-氟尿嘧啶; DXT: 多西紫杉醇; PXT: 紫杉醇; LBP: 洛铂; NDP: 奈达铂。
a表示客观有效率, b表示疾病控制率, c表示1年生存率, d表示2年生存率, e表示3年生存率, f表示放射性食管炎, g表示放射性肺炎, h表示胃肠道反应, i表示血液毒性, j表示神经毒性, k表示皮肤过敏, l表示发热, m表示低血压。
下载: 导出CSV
-
[1] HUANG F L, YU S J. Esophageal cancer: Risk factors, genetic association, and treatment[J]. Asian J Surg, 2018, 41(3): 210-215. doi: 10.1016/j.asjsur.2016.10.005
[2] WATANABE M, OTAKE R, KOZUKI R, et al. Recent progress in multidisciplinary treatment for patients with esophageal cancer[J]. Surg Today, 2020, 50(1): 12-20. doi: 10.1007/s00595-019-01878-7
[3] QIU M L, LIN J B, LI X, et al. Current state of esophageal cancer surgery in China: a national database analysis[J]. BMC Cancer, 2019, 19(1): 1064-1073. doi: 10.1186/s12885-019-6191-2
[4] SINGH D, ATTRI B K, GILL R K, et al. Review on EGFR inhibitors: critical updates[J]. Mini Rev Med Chem, 2016, 16(14): 1134-1166. doi: 10.2174/1389557516666160321114917
[5] VERA D R, EIGNER S, HENKE K E, et al. Preparation and preclinical evaluation of 177Lu-nimotuzumab targeting epidermal growth factor receptor overexpressing tumors[J]. Nucl Med Biol, 2012, 39(1): 3-13. doi: 10.1016/j.nucmedbio.2011.07.001
[6] TSUCHIDA Y, THERASSE P. Response evaluation criteria in solid tumors (RECIST): new guidelines[J]. Med Pediatr Oncol, 2001, 37(1): 1-3. doi: 10.1002/mpo.1154
[7] BATES D W, O'NEIL A C, PETERSEN L A, et al. Evaluation of screening criteria for adverse events in medical patients[J]. Med Care, 1995, 33(5): 452-462. doi: 10.1097/00005650-199505000-00002
[8] CUMPSTON M, LI T, PAGE M J, et al. Updated guidance for trusted systematic reviews: a new edition of the Cochrane Handbook for Systematic Reviews of Interventions[J]. Cochrane Database Syst Rev, 2019, 10: ED000142. http://www.researchgate.net/publication/336750574_Updated_guidance_for_trusted_systematic_reviews_a_new_edition_of_the_Cochrane_Handbook_for_Systematic_Reviews_of_Interventions
[9] CLARK H D, WELLS G A, HUËT C, et al. Assessing the quality of randomized trials: reliability of the Jadad scale[J]. Control Clin Trials, 1999, 20(5): 448-452. doi: 10.1016/S0197-2456(99)00026-4
[10] 陈玉兰, 李曙平, 练英妮. 尼妥珠单抗联合奈达铂同步放化疗治疗局部晚期食管癌的临床研究[J]. 北方药学, 2016, 13(9): 140-141. [11] 傅国林. 尼妥珠单抗在局部晚期食管癌同步放化疗中的疗效观察[J]. 中国基层医药, 2017, 24(22): 3457-3461. doi: 10.3760/cma.j.issn.1008-6706.2017.22.025 [12] 侯小霞, 常志伟, 秦艳茹. 尼妥珠单抗联合紫杉醇脂质体、顺铂同步放化疗治疗晚期食管癌的效果[J]. 河南医学研究, 2019, 28(12): 2144-2147. doi: 10.3969/j.issn.1004-437X.2019.12.010 [13] 黄丹丹, 李涛, 张军, 等. 尼妥珠单抗联合同步放化疗治疗局部晚期食管癌的近期疗效分析[J]. 中国肿瘤临床, 2012, 39(23): 1961-1963. [14] RAMOS-SUZARTE M, LORENZO-LUACES P, LAZO N G, et al. Treatment of malignant, non-resectable, epithelial origin esophageal tumours with the humanized anti-epidermal growth factor antibody nimotuzumab combined with radiation therapy and chemotherapy[J]. Cancer Biol Ther, 2012, 13(8): 600-605. doi: 10.4161/cbt.19849
[15] 李明耀, 项振飞, 胡丹飞, 等. 尼妥珠单抗联合同步放化疗治疗局部晚期食管癌效果观察[J]. 中国乡村医药, 2018, 25(24): 15-16. doi: 10.3969/j.issn.1006-5180.2018.24.007 [16] 刘慧娟, 车宇, 刘佳. 尼妥珠单抗联合同步放、化疗治疗中晚期食管癌的近期疗效观察[J]. 现代肿瘤医学, 2015, 23(18): 2587-2590. doi: 10.3969/j.issn.1672-4992.2015.18.10 [17] 周云. 尼妥珠单抗联合洛铂同步放化疗治疗局部晚期食管癌的疗效分析[J]. 临床医药文献电子杂志, 2017, 4(84): 16603-16604. doi: 10.3877/j.issn.2095-8242.2017.84.094 [18] 张云霞, 张健. 尼妥珠单抗联合同步放化疗治疗局部晚期食管癌的短期疗效观察[J]. 心理医生, 2018, 24(25): 173-174. [19] FATEHI HASSANABAD A, CHEHADE R, BREADNER D, et al. Esophageal carcinoma: Towards targeted therapies[J]. Cell Oncol (Dordr), 2020, 43(2): 195-209.
[20] 郭晓彤, 赫捷. 食管癌治疗现状及精准医学时代展望[J]. 中华肿瘤杂志, 2016, 38(9): 641-645. doi: 10.3760/cma.j.issn.0253-3766.2016.09.001 [21] TAYLOR RIPLEY R, SURMAN D R, DIGGS L P, et al. Metabolomic and BH3 profiling of esophageal cancers: novel assessment methods for precision therapy[J]. BMC Gastroenterol, 2018, 18(1): 94-99. doi: 10.1186/s12876-018-0823-x
-
期刊类型引用(11)
1. 连利媛，张玉. 新生儿呼吸窘迫综合征患儿预后情况及不良预后影响因素分析. 航空航天医学杂志. 2024(09): 1124-1126 . 
百度学术
2. 邹晴，方玉玲，彭晓瑞，谢双霞，胡艳松. 新生儿呼吸窘迫综合征患儿预后不良的影响因素. 中国民康医学. 2024(21): 8-11 . 百度学术
3. 季俊玲，木菁菁，温苗苗，赵碧茹. 新生儿呼吸窘迫综合征患儿肺出血发生情况及预后的影响因素分析. 中国妇幼保健. 2023(18): 3518-3522 . 百度学术
4. 杜睿，甄丽. 肺部超声评估在新生儿呼吸窘迫综合征中的临床应用价值. 国际呼吸杂志. 2023(09): 1077-1082 . 百度学术
5. 徐刘毅. 早期应用肺表面活性物质预防新生儿呼吸窘迫综合征的效果分析. 中国妇幼保健. 2023(24): 4858-4861 . 百度学术
6. 李卓娅，宋红，宋焕清，周川，李晶晶. 氨基末端脑钠肽前体水平在早产儿支气管肺发育不良中的临床价值. 实用临床医药杂志. 2022(10): 83-87+96 . 本站查看
7. 李紫薇，顾美群，许小志，唐莲芳，许小艳，杨景晖，毕凯，米弘瑛. 某三甲医院101例极早产儿临床资料分析. 昆明医科大学学报. 2022(06): 85-91 . 百度学术
8. 刘立静，马洪欣，杜睿，邸晓玲，顾华. 肺部超声新评分法在新生儿呼吸窘迫综合征病情评价及治疗中的应用效果. 实用临床医药杂志. 2022(21): 111-114 . 本站查看
9. 罗恒，梅玥婧，刘夕珑，张立英，卢丹. 保留胎膜囊剖宫产术在早产双胎妊娠中的应用评价. 实用临床医药杂志. 2022(23): 60-64 . 本站查看
10. 李婕. 不同剂量牛肺表面活性剂治疗新生儿呼吸窘迫综合征30例疗效观察. 药品评价. 2021(15): 939-941 . 百度学术
11. 李梦娇，李晶，马金红，张迪. 个性化的互动延续性护理干预对低出生体重早产儿体格生长的影响研究. 中国优生与遗传杂志. 2021(12): 1782-1785 . 百度学术
其他类型引用(2)
计量
- 文章访问数: 725
- HTML全文浏览量: 348
- PDF下载量: 72
- 被引次数: 13
苏公网安备 32100302010246号