目的:系统评价PARPi治疗转移性去势抵抗性前列腺癌(mCRPC)的有效性及安全性，以期为临床决策供循证医学证据。方法:依据纳入和排除标准，网络检索2015年1月～2023年6月PubMed、Web of Science、Embace、Clinicial。gov中有关PARPi治疗mCRPC的随机对照试验文献，使用RevMan5。4 及Stata17。0软件对数据进行Meta分析。结果:纳入7篇随机对照试验文献，共1 888例患者。Meta分析结果表明，与非PARPi组比较，PARPi组(PARPi联合或不联合抗激素治疗)可提高mCRPC的放射学无进展生存期(HR=0。52，95%CI=0。34～0。78)和总生存期(HR=0。72，95%CI=0。60～0。86)，差异均有统计学意义(P<0。05)。在安全性方面，PARPi组1～2级骨痛、背痛、贫血、中性粒细胞减少、恶心、呕吐、腹泻、乏力不良反应发生率明显高于非PARPi组，差异均有统计学意义(P<0。05);≥3级上述不良反应中与非PARPi组比较，PARPi组中只有恶心和贫血不良反应发生率较高，差异均有统计学意义(P<0。05)，而骨痛、背痛、中性粒细胞减少、呕吐、腹泻、乏力两组间比较差异均无统计学意义(P>0。05)。结论:与非PARPi比较，PARPi联合或不联合抗激素治疗可提高mCRPC的放射学无进展生存期和总生存期，3级及以上不良反应发生率低，值得在临床上推广应用。
Efficacy and safety of PARP inhibitors in the treatment of metastatic castration resistance prostate cancer:A meta-analysis
Objective:To systematically evaluate the efficacy and safety of PARPi in the treatment of metastatic castration re-sistance prostate cancer mCRPC to provide evidence-based medical evidence for clinical decision making.Methods:According to the inclusion and exclusion criteria,PubMed,Web of Science,Embace,and Clinicial.gov were searched for randomized con-trolled trials of PARPi for treating mCRPC from January 2015 to June 2023.A Meta-analysis was performed using RevMan5.4 and Stata17.0 software.Results:Seven randomized controlled trials involving 1 888 patients were included.The results of the me-ta-analysis showed that compared with the non-PARPi group,the PARPi group(PARPi with or without anti-hormone therapy)exhibited significantly improved radiological progression-free survival(HR:0.52,95%CI:0.34-0.78)and overall survival(HR:0.72,95%CI:0.60-0.86)of mCRPC(P<0.05).In terms of safety,the incidence of grades 1-2 bone pain,back pain,anemia,neutropenia,nausea,vomiting,diarrhea,and fatigue was significantly higher in the PARPi group than in the non-PARPi group(P<0.05).Only the incidences of nausea and anemia were significantly higher in the PARPi group than in the non-PARPi group(P<0.05),with no significant difference in bone pain,back pain,neutropenia,vomiting,diarrhea,and fatigue between the two groups(P>0.05).Conclusion:Compared with non-PARPi,the treatment of mCRPC with PARPi with or without anti-hormone therapy can improve radiological progression-free survival and overall survival,with a low incidence of grade 3 and above adverse reactions,which is worthy of clinical application.
万方数据
维普
