榄香烯联合放疗干预肺癌脑转移系统评价

CJI (Traditional Chinese Medicine) - - 中国中医药信息杂志 -

池志恒,虞舜,温雯婷

南京中医药大学,江苏 南京 210023

摘要:目的 系统评价榄香烯联合放疗干预肺癌脑转移的有效性和安全性。方法 计算机检索中国知识资源总库(CNKI)、中国生物医学文献数据库(CBM)、中文科技期刊数据库(重庆维普)、中国学术期刊数据库(万方数据)、Cochrane Library、PubMed、Embase 中榄香烯联合放疗干预肺癌脑转移的临床随机对照试验相关文献,检索范围均为建库至2016 年 10 月。按照 Cochrane 系统评价手册 5.1.0 偏倚风险评估工具对纳入文献进行质量评价,采用 RevMan5.3 软件进行 Meta 分析。结果 共纳入文献 12 篇,总计受试者 839 例。Meta

分析结果显示,与单纯放疗比较,联合使用榄香烯消退实体瘤效果更显著[OR=2.73,95%CI(1.97,3.77),

P<0.000 01],同时可明显提高患者生活质量[OR=3.85,95%CI(2.23,6.65),P<0.000 01]、缓解不良反

应[OR=4.16,95%CI(2.40,7.22),P<0.000 01]。结论 榄香烯联合放疗干预肺癌脑转移具有明确疗效,且相对安全。但临床是否应广泛采用该方案,尚需更多大样本、多中心、高质量的临床随机对照试验验证。关键词:榄香烯;肺癌;脑转移;放疗;系统评价

DOI:10.3969/j.issn.1005-5304.2017.11.023

中图分类号:R2-05;R273.42 文献标识码:A 文章编号:1005-5304(2017)11-0096-05

Systematic Evaluation of Elemene Combined with Radiotherapy for Intervention in Brain Metastasis from Pulmonary Neoplasms

CHI Zhi-heng, YU Shun, WEN Wen-ting (Nanjing University of Chinese Medicine, Nanjing 210023, China)

Abstract: Objective To systematically evaluate the effectiveness and safety of Elemene combined with radiotherapy for intervention in brain metastasis from pulmonary neoplasms. Methods Articles of clinical randomized controlled trials about Elemene combined with radiotherapy for intervention in brain metastasis from pulmonary neoplasms from the establishment of the databases to October of 2016 from CNKI, CBM, Chongqing Weipu, Wanfang database, Cochrane Library, PubMed and Embase were retrieved by computers. Bias risk assessment tools in Cochrane systematic evaluation handbook 5.1.0 was used to conduct quality evaluation for included articles. RevMan5.3 software was used to carry out Meta-analysis. Results Totally 12 articles and 839 patients were included. Results of Meta-analysis showed that Elemene combined with radiotherapy had more obvious curative effect on narrowing the neoplasm compared with pure radiotherapy [OR=2.73, 95%CI (1.97, 3.77), P<0.000 01], and improve patients’ life quality at the same time [OR=3.85, 95%CI (2.23, 6.65), P<0.000 01], and relieve adverse reactions [OR=4.16, 95%CI (2.40, 7.22), P<0.000 01]. Conclusion Elemene combined with radiotherapy for intervention in brain metastasis from pulmonary neoplasms shows confirmed efficacy, and is relatively safe. But whether the program should be widely used in clinic, more large sample, multi-center, and high-quality clinical randomized controlled trials are still needed.

Key words: Elemene; pulmonary neoplasms; brain metastasis; radiotherapy; systematic assessment

脑转移瘤是各系统肿瘤最严重的并发症。肺癌更易转移至脑,数据显示50%脑转移瘤的原发肿瘤是肺癌[1]。根据《中国原发性肺癌诊疗规范(2015 年版)》[2] ,

基金项目:江苏省优势学科建设工程项目(2016年);江苏省

中医药防治肿瘤协同创新中心课题(012092002005)

通讯作者:虞舜,E-mail:yushun6336@163.com 立体定向放射治疗是肺癌脑转移的常规治疗手段,但单纯放疗不良反应较大,患者术后生活质量不佳。榄香烯是中药莪术挥发油的提取物,基础药理研究表明其有广泛的抗癌活性,能够在肺组织中保持较高的浓度并能透过血脑屏障[3],故被广泛同步使用于肺癌脑转移放疗中。然而联合治疗尚未见大样本的临床疗效系统评价,故本研究采用 Cochrane 系统评价的方法,

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