作　　者： (陈莉玲）; (张考梅）; (杨婷）; (杨艳芳）; (黄敏）;

机构地区： 四川大学华西公共卫生学院,成都610041

出　　处： 《中国循证医学杂志》 2017年第9期1043-1050,共8页

摘　　要： 目的系统评价^(89)SrCl_2治疗恶性肿瘤骨转移的疗效和安全性。方法计算机检索Pub Med、EMbase、The Cochrane Library(2016年12期)、MEDLINE、CBM、VIP、CNKI和Wan Fang Data数据库,搜集关于^(89)SrCl_2治疗恶性肿瘤骨转移的随机对照试验(RCT),检索时限均从建库至2016年12月。由2位研究员独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用Rev Man 5.3软件进行Meta分析。结果最终纳入19个RCT,共1 899例患者。Meta分析结果显示,^(89)SrCl_2联合治疗组的骨痛完全缓解率[RR=1.53,95%CI(1.16,2.01),P=0.002]、骨痛缓解总有效率[RR=1.33,95%CI(1.22,1.45),P<0.001]、骨转移病灶显效率[RR=1.61,95%CI(1.20,2.16),P=0.002]、骨转移病灶总有效率[RR=1.61,95%CI(1.26,2.08),P<0.001]、生活质量改善率[RR=1.44,95%CI(1.06,1.97),P=0.02]、闪烁痛发生率[RR=10.35,95%CI(2.01,53.37),P=0.005]、白细胞减少发生率[RR=2.49,95%CI(1.84,3.37),P<0.001]和血小板减少发生率[RR=2.64,95%CI(1.76,3.97),P<0.001]均高于对照组。结论 ^(89)SrCl_2联合治疗较无^(89)SrCl_2联合治疗效果好。受纳入研究的数量和质量限制,上述结论尚需要开展更多研究予以验证。 Objective To systematically review the efficacy and safety of 89^SRCl2 for bone metastases. Methods Databases including PubMed, EMbase, The Cochrane Library （Issue 12, 2016）, MEDLINE, CBM, VIP, CNKI and WanFang Data were electronically searched from inception to December 2016 to collect randomized controlled trials （RCT） about 89^SrCl2 in the treatment of bone metastases. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of included studies. Then meta-analysis was performed by using RevMan 5.3 software. Results A total of 19 RCTs involving 1 899 patients were included. The results ofmeta-analysis showed that： compared to the group without 89SrC12, group of 89^SrCl2 combined with other treatments had benefits for complete relief of bone pain （RR=1.53, 95%CI 1.16 to 2.01, P=0.002）, total relief of bone pain （RR=1.33, 95%CI 1.22 to 1.45, P〈0.001）, bone metastases complete response rate （RR= 1.61, 95%CI 1.20 to 2.16, P=0.002）, bone metastases total response rate （RR= 1.61, 95%CI 1.26 to 2.08, P〈0.001）, improvement of quality of life （RR= 1.44, 95%CI 1.06 to 1.97, P=0.02）. The proportion of pain flare （RR=10.35, 95%CI 2.01 to 53.37, P=0.005）, leucopenia （RR=2.49, 95%CI 1.84 to 3.37, P〈0.001） and thrombocytopenia （RR=2.64, 95%CI 1.76 to 3.97, P〈0.001） in the 89^SrCl2 group were higher than that in the control group. Conclusion 89^SrCl2 combined with the other treatments is better for bone metastases than without 89^SrCl2. Due to the limited quantity and quality of included studies, the above results should be verify by more high quality studies.

关 键 词： 锶 骨肿瘤 肿瘤转移 分析 随机对照试验