本文關(guān)鍵詞：貝伐單抗聯(lián)合化療對復(fù)發(fā)性上皮性卵巢癌的療效及安全性的系統(tǒng)評價　出處：《吉林大學(xué)》2015年碩士論文　論文類型：學(xué)位論文

  更多相關(guān)文章： 復(fù)發(fā)性卵巢癌 上皮性 貝伐單抗 化療 療效 安全性 meta分析

【摘要】：背景及目的： 上皮性卵巢癌是女性生殖系統(tǒng)致死率較高的惡性腫瘤之一，其發(fā)病隱匿，目前臨床上缺乏可靠的早期診斷的方法。上皮性卵巢癌的患者經(jīng)過理想的腫瘤細(xì)胞減滅術(shù)及術(shù)后的標(biāo)準(zhǔn)化療后，仍有部分患者會復(fù)發(fā)，復(fù)發(fā)后的治療比較困難，目前沒有統(tǒng)一的治療方案。因此，探討卵巢癌復(fù)發(fā)后的治療尤為重要。本文旨在通過循證醫(yī)學(xué)的方法探討貝伐單抗聯(lián)合標(biāo)準(zhǔn)化療治療復(fù)發(fā)性上皮性卵巢癌的療效和安全性,為貝伐單抗的療效和安全性提供循證醫(yī)學(xué)的證據(jù)。 研究方法： 檢索Pubmed數(shù)據(jù)庫、EMbase、Cochrane Library、Web of science等外文數(shù)據(jù)庫，CNKI、CBM、VIP及萬方數(shù)據(jù)庫，并手工檢索《中華婦產(chǎn)科學(xué)雜志》、《現(xiàn)代婦產(chǎn)科學(xué)進(jìn)展》《國際婦產(chǎn)科學(xué)》《實用婦產(chǎn)科學(xué)》等婦產(chǎn)科學(xué)雜志。檢索自建庫至2014年12月之間發(fā)表的全部文獻(xiàn)。根據(jù)之前所設(shè)定的納入標(biāo)準(zhǔn)和排除標(biāo)準(zhǔn)對文獻(xiàn)進(jìn)行篩選，根據(jù)篩選出的研究中治療方案的不同將數(shù)據(jù)分為2組：貝伐單抗聯(lián)合化療組和單純化療組。最后有3篇文章入選，共909例患者。提取納入文獻(xiàn)中的各組數(shù)據(jù)，利用Revman5.3軟件對各組數(shù)據(jù)進(jìn)行meta分析，得出試驗組和對照組的無進(jìn)展生存期和總生存期的森林圖，和各項毒性反應(yīng)的森林圖。 結(jié)果： 1.貝伐單抗聯(lián)合化療（試驗組）和單純化療（對照組）在延長復(fù)發(fā)性上皮性卵巢癌患者無進(jìn)展生存期方面有統(tǒng)計學(xué)意義[P＜0.00001， HR=0.48,95%CI(0.41,0.56)]，試驗組能延長患者的無進(jìn)展生存期。在提高復(fù)發(fā)性上皮性卵巢癌患者總生存期方面無統(tǒng)計學(xué)意義[P=0.48＞0.05， HR=0.94,95%CI(0.78,1.12)]。表明貝伐單抗聯(lián)合化療并不能延長患者的總生存期。在增加復(fù)發(fā)性上皮性卵巢癌患者發(fā)生高血壓[P=0.03＜0.05， RR=10.45,95%CI(1.22,89.82)]、蛋白尿[P=0.0007，RR=9.35,95%CI(2.57,34.10)]、動脈血栓[P=0.03＜0.05， RR=4.43,95%CI(1.14,17.19)]、出血癥狀[P=0.007，， RR=3.59,95%CI(1.41,9.16)]的風(fēng)險方面有統(tǒng)計學(xué)意義，不會增加復(fù)發(fā)性上皮性卵巢癌患者發(fā)生中性粒細(xì)胞減少[P=0.73＞0.05，RR=0.94,95%CI(0.68,1.31)]、腸穿孔[P=0.14＞0.05，RR=9.10,95%CI(0.49,167.79)]、腸膿腫及瘺[P=0.32＞0.05，RR=2.31,95%CI(0.44,12.07)]、充血性心衰[P=0.74＞0.05，RR=1.28,95%CI(0.29,5.71)]、靜脈血栓[P=0.81＞0.05，RR=0.92,95%CI(0.48,1.77)]、可逆性后部白質(zhì)腦病綜合征(RPLS)[P=0.15＞0.05，RR=4.85,95%CI(0.56,41.63)]、傷口愈合并發(fā)癥[P=0.32＞0.05，RR=4.72,95%CI(0.23,97.75)]的風(fēng)險。 結(jié)論： 1.貝伐單抗聯(lián)合化療與單純化療組療效指標(biāo)的meta分析結(jié)果顯示：加用貝伐單抗可以延長復(fù)發(fā)性上皮性卵巢癌患者的無進(jìn)展生存期（PFS），但對于總生存期（OS）無明顯差異。 2.貝伐單抗聯(lián)合化療與單純化療組毒性反應(yīng)的meta分析結(jié)果顯示：加用貝伐單抗可以增加復(fù)發(fā)性上皮性卵巢癌患者發(fā)生高血壓、蛋白尿、動脈血栓、出血癥狀的風(fēng)險，不會增加復(fù)發(fā)性上皮性卵巢癌患者發(fā)生中性粒細(xì)胞減少、腸穿孔、腸膿腫及瘺、充血性心衰、靜脈血栓、可逆性后部白質(zhì)腦病綜合征（RPLS）、傷口愈合并發(fā)癥的風(fēng)險。
[Abstract]:Background and purpose:
Ovarian cancer is one of malignant tumor with high death rate of female reproductive system, the incidence of occult, the lack of reliable clinical early diagnosis method. Epithelial ovarian cancer patients after the tumor reduction standard chemotherapy cytoreductive surgery and after surgery, some patients will relapse, recurrence after treatment more difficult, there is no unified treatment. Therefore, to explore the treatment of recurrent ovarian cancer is particularly important. The curative effect and safety of this paper aims to explore the methods of evidence-based medicine bevacizumab combined with standard chemotherapy for treatment of recurrent epithelial ovarian cancer, provide evidence-based medical evidence for the efficacy and safety of bevacizumab.
Research methods:
The Pubmed database was searched EMbase, Cochrane Library, Web of science, CNKI, CBM, database, VIP and Wanfang database, and Chinese Journal of Obstetrics and Gynecology manual retrieval < >, < > international modern progress in obstetrics and gynaecology obstetrics and Gynecology Obstetrics and Gynecology > > Practical Journal of Obstetrics and gynecology. All published literature retrieval from inception to December 2014. Based on previously set inclusion criteria and exclusion criteria for screening of literature, according to the treatment study screened in different data will be divided into 2 groups: bevacizumab plus chemotherapy group and chemotherapy group. The 3 articles were selected, a total of 909 patients were included. The extraction of data in the literature. Meta analysis of the data using Revman5.3 software, the forest plot progression free survival and overall survival of the test group and control group, and the toxicity of the forest.
Result錛

本文編號：1377999