吡柔比星与α-干扰素联用预防膀胱癌术后复发有效性及安全性的 Meta 分析

摘要

目的：评价吡柔比星与α-干扰素联用预防膀胱癌术后复发的有效性及安全性。方法遵循循证医学的原则，计算机检索 PubMed、中文期刊全文数据库（CNKI）和万方数据库，纳入符合入选标准的关于吡柔比星与α-干扰素联用预防膀胱癌术后复发有效性及安全性的随机对照试验的文献并评价质量，应用 RevMan 5.1对纳入研究进行异质性检验和效应值 OR 合并。结果①共纳入5个符合要求的病例-对照研究，包括327例患者，其中吡柔比星与α-干扰素联用162例，单用吡柔比星165例；②根据随机方法、分配隐藏、盲法、退出或失访、意向性分析和基线情况的描述对纳入研究进行质量评分，结果质量均为 B 级；③Meta 分析结果显示随访1年时吡柔比星与α-干扰素联用膀胱癌术后复发率与单用吡柔比星比较，OR ＝0.23，P ＜0.05，两组比较差异有统计学意义；随访2年时膀胱癌术后复发率与单用吡柔比星比较，OR ＝0.35，P ＜0.05，两组比较差异有统计学意义。吡柔比星与α-干扰素联用后出现膀胱刺激症状与单用吡柔比星比较，OR ＝0.63， P ＞0.05，尚不能认为两组差异有统计学意义。结论吡柔比星与α-干扰素联用组的术后复发率较单用吡柔比星组低、效果好。%Objective To evaluate the efficiency and safety of pirarubicin with interferon-alpha for postoperative recurrence of bladder cancer. Methods Following the principle of evidence-based medicine,randomized controlled trials of the effect and safety of pirarubicin with interferon-alpha for postoperative recurrence of bladder cancer enrolled by searching the databases,such as PubMed,Chi-nese journal full-text database (CNKI)and Wanfang database. All eligible studies were identified and the quality of the included studies were assessed.The RevMan 5.1 was applied for heterogeneity test and combined ORs (95% CIs )calculation. Results Five case-control studies were included in the Meta-analysis,totally covering 327 cases(162 in pirarubicin with interferon-alpha group,165 in inter-feron-alpha group);In term of randomization,allocation concealment and blinding,patients quit or lost,intent-to-treat(ITT)analysis,and group baseline,all the studies were graded B.The Meta-anal-ysis results showed that there was significant difference in recurrencerate after followed up for 1 or 2 years between pirarubicin combined with interferon-alpha and pirarubicin alone (OR =0.23 or 0.35, P <0.05),but not in irritation sign of bladder between pirarubicin combined with interferon-alpha and pirarubicin alone (OR =0.63,P >0.05). Conclusions Pirarubicin in coordination with inter-feron-alpha would be an effective remedy to prevent the postoperative recurrence of bladder cancer.