局部晚期乳腺癌动脉介入化疗的疗效及预后:系统评价和Meta分析
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国家重点研发计划(2016YFC0905900);国家自然科学基金(81872365);江苏省333高层次人才培养工程;南京医科大学创新团队建设项目(JX102GSP201727)


Efficacy and prognosis of interventional chemotherapy for locally advanced breast cancer:a systematic review and Meta⁃analysis
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    摘要:

    目的:探究局部晚期乳腺癌患者行动脉介入化疗后的疗效及预后。方法:计算机检索PubMed、中国知网、维普、万方数据库,收集所有关于局部晚期乳腺癌动脉介入化疗的原始文献,检索时间截至2018年8月,对符合入选标准的文献进行Meta分析。结果:共纳入14个随机对照试验(RCT),共1 200例患者。分析提示局部晚期乳腺癌患者术前使用动脉介入化疗的疗效比全身静脉化疗更好(RR=1.446,95%CI:1.273~1.642,P<0.05),治疗后复发转移和死亡人数更少(RR=0.564,95%CI:0.336~0.946,P<0.05),5年完全生存率更高(RR=1.239,95%CI:1.097~1.398,P<0.05),同时有降低全身不良反应率的趋势(P<0.05)。结论:局部晚期乳腺癌患者术前使用动脉介入化疗比全身静脉化疗具有更好的疗效和预后,且伴有更少的全身不良反应。

    Abstract:

    Objective:To analysis the efficacy and prognosis of arterial interventional chemotherapy in locally advanced breast cancer patients. Methods:PubMed,The Chinese knowledge network,VIP and Wanfang databases were retrieved to collect all the original literature about “arterial interventional chemotherapy for locally advanced breast cancer” up to August 2018. Then a meta-analysis was carried out on the literatures in accordance with the inclusion criteria. Results:A total of 14 randomized controlled trials(RCT)involving 1 200 patients were included. The results showed that the therapeutic effect of arterial interventional chemotherapy for locally advanced breast cancer was better than that of systemic venous chemotherapy(RR=1.446,95%CI:1.273~1.642,P<0.05),and the recurrence,metastasis and mortality rates were lower after treatment(RR=0.564,95%CI:0.336~0.946,P<0.05),and the 5-year overall survival rate was higher(RR=1.239,95%CI:1.097~1.398,P<0.05),and tend to reduce the incidence rate of systemic adverse reactions(P<0.05). Conclusion:Preoperative arterial interventional chemotherapy in patients with locally advanced breast cancer has better therapy responses and prognosis than neoadjuvant systemic venous chemotherapy,and has fewer systemic adverse reactions.

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茆智翔,陈 秀,徐 迪,张 薇,丁 莉,唐金海.局部晚期乳腺癌动脉介入化疗的疗效及预后:系统评价和Meta分析[J].南京医科大学学报(自然科学版),2019,(5):786-792

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  • 收稿日期:2018-07-23
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  • 在线发布日期: 2019-05-31
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