本文選題：聚腺苷二磷酸核糖聚合酶(PARP) + 抑制劑��； 參考：《山西醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:評價(jià)PARP抑制劑對復(fù)發(fā)性上皮性卵巢癌的治療效果及風(fēng)險(xiǎn),為復(fù)發(fā)性上皮性卵巢癌患者的繼續(xù)治療提供更有效、更安全的治療方案。方法:通過計(jì)算機(jī)檢索中國生物醫(yī)學(xué)文獻(xiàn)庫、相關(guān)期刊論文、萬方數(shù)據(jù)庫、N CBI、Cochrane Library、Medline數(shù)據(jù)庫自建庫以來截止2017年2月28日所有關(guān)于PARP抑制劑治療復(fù)發(fā)性上皮性卵巢癌的隨機(jī)臨床對照實(shí)驗(yàn)。按照Cochrane系統(tǒng)評價(jià)手冊5.3版推薦的RCT標(biāo)準(zhǔn)評價(jià)納入研究質(zhì)量,采用Cochrane協(xié)作網(wǎng)提供的Revman5.3軟件進(jìn)行Meta分析�？偵嫫�(overall survival,OS)和無進(jìn)展生存期(progression free survival,PFS)合并統(tǒng)計(jì)量為風(fēng)險(xiǎn)比(hazard ratio,HR),客觀應(yīng)答率(Objective response rate,ORR)、不良反應(yīng)合并為相對危險(xiǎn)度(relative ratio,RR)。結(jié)果:搜索截止2017年2月28日為止的相關(guān)文獻(xiàn)研究,共納入4項(xiàng)RCT研究,包括3項(xiàng)Ⅱ期臨床試驗(yàn)及1項(xiàng)Ⅲ期臨床試驗(yàn),共計(jì)995名來自世界各地的復(fù)發(fā)性卵巢癌患者,其中BRCA突變者420人。Meta分析結(jié)果顯示,相比于對照組,聚腺苷二磷酸核糖聚合酶(PARP)抑制劑能明顯改善鉑類敏感患者的無進(jìn)展生存期(HR0.5195%CI 0.34-0.77 P0.0001),尤其是對于BRCA突變者(HR0.31 95%CI 0.16-0.61 P=0.0008)。然而對于總生存期無明顯改善(全部HR 0.99 95%CI 0.78-1.25 P=0.94;突變組HR0.76 95%CI 0.45-1.31 P=0.96)。大多數(shù)患者在治療中表現(xiàn)出良好的客觀應(yīng)答率。對該類藥物引起的不良反應(yīng)的分析顯示,聚腺苷二磷酸核糖聚合酶(PARP)抑制劑的主要不良反應(yīng)為惡心、疲乏、嘔吐、腹瀉、腹痛、貧血、便秘、嗜中性粒細(xì)胞減少等臨床癥狀,且主要為1-2級反應(yīng)(不需要藥物干預(yù))。全部級別的不良事件中疲乏、嘔吐、惡心、貧血、嗜中性粒細(xì)胞減少組間比較具有統(tǒng)計(jì)學(xué)意義,但是3-4級(需要藥物干預(yù))不良事件中貧血和嗜中性粒細(xì)胞減少組間對比具有統(tǒng)計(jì)學(xué)意義。結(jié)論:研究分析顯示,聚腺苷二磷酸核糖聚合酶(PARP)抑制劑能夠明顯改善鉑類敏感的復(fù)發(fā)性上皮性卵巢癌患者的無進(jìn)展生存期(PFS),尤其是對于BRCA突變患者,對于非鉑類敏感復(fù)發(fā)性上皮性卵巢癌患者的治療效果需要進(jìn)一步研究。PARP抑制劑對于總生存期(OS)的改善尚無明顯證據(jù),需要更多的研究及數(shù)據(jù)進(jìn)一步驗(yàn)證。大多數(shù)患者對于該類藥物在治療過程中表現(xiàn)出了較好的應(yīng)答率。但是PARP抑制劑在臨床應(yīng)用中可能出現(xiàn)惡心、疲乏、嘔吐、腹瀉、腹痛、貧血、便秘、嗜中性粒細(xì)胞減少等不良事件,主要為1-2級反應(yīng)(不需要藥物干預(yù)),其中貧血和嗜中性粒細(xì)胞減少的3-4級不良反應(yīng)顯著,臨床上需采取有效措施進(jìn)行預(yù)防和治療。
[Abstract]:Objective: to evaluate the efficacy and risk of PARP inhibitor in the treatment of recurrent epithelial ovarian cancer, and to provide a more effective and safe treatment scheme for patients with recurrent epithelial ovarian cancer. Methods: the Chinese Biomedical Database and the full text Database of Chinese Journals were searched by computer. All randomized controlled trials of PARP inhibitors in the treatment of recurrent epithelial ovarian cancer have been conducted since the establishment of the Wanfang database since the establishment of the Cochrane Library Medline database on February 28, 2017. According to the research quality of RCT standard evaluation recommended in 5.3 edition of Cochrane system evaluation manual, the Meta analysis is carried out with Revman5.3 software provided by Cochrane cooperation network. Total survival rate and progressive free survival (PFSs) combined with risk ratio, objective response rate, and adverse reactions were associated with relative risk and relative risk. Results: a total of 4 RCT studies, including 3 phase 鈪，

本文編號(hào)：1807800