贝伐单抗治疗结直肠癌疗效和安全性的meta分析

Efficacy and safety of bevacizumab in treatment of colorectal cancer ： a meta-analysis

关键词:  贝伐单抗  结直肠肿瘤癌  随机对照  meta分析

Key words:  bevacizumab  colorectal cancer  randomized controlled trials  meta-analysis

摘要:

目的评价贝伐单抗治疗结直肠癌的疗效和安全性。方法检索2003年1月至2013年6月期间发表的 关于贝伐单抗治疗结直肠癌的随机对照试验。主要观察终点是总体生存时间，次要观察终点是无进展生存时间、 总体缓解率和安全性。由两名研究者独立筛选文献并提取资料，用Stata 12.0软件进行统计学处理。结果最终 纳入10个研究和6 977例受试对象。meta分析结果显示，与单纯化疗组相比,使用贝伐单抗能延长结直肠癌的总 体生存时间（H/? =0.848,95% C/: 0.747 -0.963)和无进展生存时间（=0.617,95% C/: 0.530 ~0.719)，提高 总体缓解率（0及=1.627,95%^7: 1.199 -2.207);贝伐单抗虽增加彡3级高血压、蛋白尿、出血、血栓以及胃肠 道穿孔的发生率（P<0.05)，但严重不良事件的发生率较低。结论贝伐单抗治疗结直肠癌疗效更佳，且安全 性南。

Abstract:

Objective To assess the efficacy and safety of bevacizumab in treatment of colorectal cancer. Methods Randomized controlled trials of bevacizumab in treatment of colorectal cancer from January 2003 to June 2013 were collected from medical databases. The primary endpoint was overall survival (OS)，and the secondary endpoints were progression-free survival (PFS)，overall response rate (ORR) and adverse events (AEs). Two reviewers individually extracted data. The statistical analysis was performed with Stata 12.0. Results Ten studies including 6 977 cases were finally adopted. Our meta-analysis was in favor of bevacizumab to patients with colorectal cancer in terms of overall survival (HR =0. 848,95% Cl： 0. 747 -0.963)，progression-free survival (HR =0.617, 95%Cl： 0.530 - 0.719)，and overall response rate (OR = 1.627，95% Q： 1. 199 - 2. 207). Regarding safety, higher rates of grade ^3 hypertension, proteinuria,bleeding, thrombosis，gastrointestinal perforation were observed in the bevacizumab treatment group (P < 0.05), but the incidence of serious toxicity was very low. Conclusion The clinical application of bevacizumab is effective and safe for treatment of colorectal cancer.