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目的系统评价紫杉醇静脉滴注联合铂类药物腹腔灌注治疗卵巢癌的疗效及安全性。方法计算机检索Pub Med、CNKI、VIP、万方等数据库,收集紫杉醇联合铂类药物静脉滴注为对照组,以紫杉醇静脉滴注联合铂类药物腹腔灌注治疗卵巢癌为试验组的随机对照研究,检索年限均为建库开始至2015年12月,由2名研究者独立对纳入研究进行质量评价、数据提取,采用Rev Man 5.2统计软件对同质性结果进行合并分析。结果共纳入14项研究,合计1030例患者。Meta分析显示,与紫杉醇静脉滴注联合铂类药物静脉滴注相比,紫杉醇静脉滴注联合铂类药物腹腔灌注可显著提高近期临床有效率和远期生存率,差异性比较有统计学意义(P<0.01);在骨髓抑制方面无显著性差异(P>0.05),但肝肾毒性、外周神经毒性和肌肉关节痛较高,差异性比较有统计学意义(P<0.01)。结论紫杉醇静脉滴注联合铂类药物腹腔灌注能提高卵巢癌化疗的临床疗效,但也增加了肝肾毒性、外周神经毒性和肌肉关节痛,提示临床医生应根据患者特点个体化选择。
Objective To systematically evaluate the efficacy and safety of intravenous infusion of paclitaxel combined with intraperitoneal perfusion of platinum on ovarian cancer. Methods The databases of Pub Med, CNKI, VIP and Wanfang were searched by computer, and paclitaxel combined with platinum drug was collected as control group. Paclitaxel intravenous infusion combined with platinum-based intraperitoneal perfusion was used to treat ovarian cancer as a randomized controlled trial. The search period was from the beginning of construction to December 2015. Two researchers independently evaluated the quality of the included studies and extracted the data. The analysis results of the homogeneity were analyzed by using Rev Man 5.2 statistical software. Results A total of 14 studies were included, totaling 1,030 patients. Meta-analysis showed that compared with IV paclitaxel intravenous infusion of platinum drugs, intravenous infusion of paclitaxel combined with intraperitoneal injection of platinum drugs can significantly improve the short-term clinical and long-term survival rates, the difference was statistically significant ( P <0.01). There was no significant difference in myelosuppression (P> 0.05). However, the hepatorenal toxicity, peripheral neurotoxicity and muscular joint pain were higher, the difference was statistically significant (P <0.01). Conclusion Intraperitoneal infusion of paclitaxel combined with platinum can improve the clinical efficacy of chemotherapy for ovarian cancer, but also increase the hepatorenal toxicity, peripheral neurotoxicity and muscle and joint pain, suggesting that clinicians should choose individual according to the characteristics of patients.