【摘要】 目的:通过Meta分析,探讨贝伐珠单抗联合化疗一线治疗转移性乳腺癌(MBC)的有效性和安全性。方法:通过PubMed、Medline、EMBASE、Cochrane图书馆、ASCO论文集、中国期刊全文数据库、万方数据库等数据库检索国内外已发表和未发表的相关文献。由2位评价者分别按检索策略收集资料,按纳入标准入选,主要对无疾病进展生存期(PFS)、总生存期(OS)、客观缓解率(ORR)和3～4级不良反应事件的发生率进行Meta分析。结果:共纳入5个随机对照临床研究(RCT),联合使用贝伐珠单抗一线化疗组PFS(RR=1.50;95%CI:1.31～1.72,P<0.001),OS(RR=1.06;95%CI:1.02～1.11,P=0.005)和ORR(RR=1.37;95%CI:1.26～1.49,P<0.001)与单药化疗组相比差异有统计学意义,3～4级高血压(RR=7.74;95%CI:1.33～45.00,P<0.001)和蛋白尿(RR=4.59;95%CI:2.15～9.79,P<0.001)的发生率与单药化疗组相比差异有统计学意义,而出血和血栓事件的发生率差异无统计学意义。结论:联合使用贝伐珠单抗一线治疗能显著提高MBC患者PFS、OS和ORR,可能增加高血压和蛋白尿的发生率,但不显著增加出血和血栓事件的发生率。更多还原

【Abstract】 OBJECTIVE: Conducted meta-analysis to verify the clinical efficacy of bevacizumab for the front-line treatment of metastatic breast cancer.METHODS: All available literature of randomized clinical controlled trails about bevacizumab and MBC was pooled from PubMed,Medline,EMBASE,Cochrane library database,ASCO,CNKI.Wangfang database and so on.The meta-analysis compared the progression free survival,overall survival,objective release rate and incidence of WHO 3/4 grade adverse events in MBC patients.RESULTS: Five randomized controlled trials were included by two reviewers.There was statistical differences between the study group(bevacizumab combination group) and the control group(monotherapy group) in PFS(RR=1.50;95%CI: 1.31-1.72,P<0.001) and OS(RR=1.06;95%CI: 1.02-1.11,P=0.005) and ORR(RR=1.37;95%CI: 1.26-1.49,P<0.001).There was statistical differences between the study group and control group in 3~4 grade hypertension(RR=7.74;95%CI: 1.33-45.00,P<0.001) and proteinuria(RR=4.59;95%CI: 2.15-9.79,P<0.001),but no statistical differences in bleeding and thromboembolic events.CONCLUSIONS:Combination of bevacizumab shows a significant improvement in PFS and OS and ORR in MBC patients,may increase the incidence of hypertension and proteinuria,but no significant increase in bleeding and thrombotic events.更多还原