【摘要】 目的用Meta分析的方法系统评价白介素-2(IL-2)联合干扰素(IFN)与单用IL-2治疗晚期肾癌的疗效和安全性。方法计算机检索PubMed、Embase、Cochrane Library、中国生物医学文献数据库、中国期刊全文数据库、中文科技期刊全文数据库以及重要的学术论文网站关于IL-2联合IFN与单用IL-2治疗晚期肾癌的随机对照试验,按照Cochrane handbook制作Meta分析,用Rev Man5.0软件统计分析。结果共纳入6篇随机对照试验(共842例患者)文献。Meta分析结果显示:IL-2联合IFN与单用IL-2相比治疗晚期肾癌在有效率〔RR=1.35,95%CI(0.59,3.09)〕和1年病死率〔RR=0.90,95%CI(0.72,1.12)〕方面差异均无统计学意义。亚组分析结果提示,与单用高剂量IL-2相比,常规剂量的IL-2联合IFN治疗在有效率方面差异有统计学意义〔RR=2.11,95%CI(1.14,3.90)〕;而相同剂量的IL-2联合IFN治疗并不能提高患者的有效率〔RR=1.09,95%CI(0.35,3.39)〕。结论当前研究证据表明与单用IL-2相比,IL-2联合IFN并不能改善晚期肾癌患者的有效率和病死率,而高剂量的IL-2治疗效果更佳。更多还原

【Abstract】 Objective To systematically review the efficacy and safety of interleukin-2(IL-2) alone and IL-2 combined with interferon in treating advanced renal cancer using meta analysis.Methods We searched PubMed,Embase,the Cochrane Library,Chinese biomedical literature database,Chinese Scientific Journals full-text database,Chinese Journal full-text database,and major conference proceeding for randomized controlled trials comparing IL-2 alone with interferon plus IL-2 for treatment of patients with advanced renal cancer.We carry out meta analysis according to Cochrane handbook.We analyzed the data using Review Manager 5.0 provided by Cochrane collaboration.Results Six randomized controlled trials involving 842 patients were included.Meta analysis showed that no significant difference existed between IL-2 alone and interferon plus IL-2 in response rate(RR=1.36,95%CI(0.59,3.09)) and mortality rate at one year(RR=0.90,95%CI(0.72,1.12)).Subgroup meta analysis showed that high-dose IL-2 provided superior response rate over routine-dose IL-2 and interferon(RR=2.10,95%CI(1.14,3.87)),while routine-dose IL-2 did not provide higher response rate(RR=0.67,95%CI(0.40,1.11)).Conclusion Current clinical evidence might confirm that combination therapy does not influence response rate or mortality rate compared with IL-2 alone,but high-dose IL-2 provide superior efficacy.更多还原