鸦胆子油乳注射液联合放疗治疗食管癌的Meta分析

摘要

Objective To evaluate the advantage and clinical value of javanica oil emulsion injection combined with radiotherapy for esophageal carcinoma. Method Randomized controlled trials (RCTs) concerning javanica oil emulsion injection combined with radiotherapy for esophageal carcinoma were made on electronic databases of CBM, CNKI, Wangfang, VIP and PubMed from 1990 to February 28, 2015. Quality of the included RCTs was assessed by Jadad scoring , and Meta-analyses were performed by RevMan5.3 software. Results Seven RCTs involving 575 patients were included in Meta-analysis. All studies were in low quality. The results of Meta-analyses showed that Javanica oil emulsion injection combined with radiotherapy for esophageal carcinoma, compared with control groups, could increase the recent curative effect (P < 0.000 01) and improve the quality of live (P = 0.000 8), decrease the hematologic toxicities (P = 0.03) and the incidence rate of radioaction esophagitis (P = 0.02), but not enough evidence was found to prove that it can enhance survival rate (P = 0.25). Conclusions The results of Meta-analysis indicate that javanica oil emulsion injection may have therapeutic effects on the treatment of esophageal carcinoma. Yet the effects of javanica oil emulsion injection still need to be confirmed by large multi-center randomized controlled trials.%目的：应用Meta分析评价鸦胆子油乳注射液联合放疗与单纯放疗相比在食管癌治疗中的优越性和临床意义。方法：检索CNKI、CBM、万方、维普和PubMed 等电子数据库，检索时间1990年至2015年2月28日，纳入鸦胆子油乳注射液联合放疗治疗食管癌的随机对照研究，用Jadad 量表评价纳入研究的质量，应用RevMan5．3软件进行数据分析。结果：共纳入7个随机对照临床试验，包括575例患者。纳入文献均为低质量研究。 Meta分析结果表明：与对照组相比，鸦胆子油乳注射液联合放疗可以提高治疗的近期疗效（P ＜0．00001）和生存质量（P ＝0．0008），减轻血液学毒性（P ＝0．03）和放射性食管炎的发生率（P ＝0．02），但不能提高患者的2年生存率（P ＝0．25）。结论：鸦胆子油乳联合放疗治疗食管癌具有一定的减毒增效作用，但仍需大样本多中心的随机对照临床试验进一步证实其临床疗效。