5%咪喹莫特乳膏治疗基底细胞癌Meta分析

目的以循证医学的方法对5%咪喹莫特乳膏治疗基底细胞癌的疗效与安全性进行系统评价。方法检索PubMed、Ovid、Web of Science、UMI、elsevier,以及Cochrane图书馆,纳入比较5%咪喹莫特乳膏与安慰剂的随机对照试验,由两名评价者独立提取资料并进行方法学质量评估。试验数据的统计分析采用Cochrane协作网提供的Rev Man4.2.8软件进行。结果最终纳入7个RCT,对其治疗浅表型基底细胞癌与结节型基底细胞癌进行了Meta分析,显示其与对照组相比,差异具有统计学意义,合并后前者RR=12.66(95%CI,3.56~45.06),后者RR=5.24(95%CI,2.54~10.81),没有报道与5%咪喹莫特乳膏临床应用相关的严重系统性不良反应。结论现有临床证据表明,5%咪喹莫特乳膏治疗浅表型基底细胞癌有确切的疗效与较好的安全性。疗效与剂量具有相关性,但每日2次与每日1次应用5%咪喹莫特乳膏临床疗效无差异。

Meta-analysis of the Effectiveness of 5% Imiquimod in Treatment of Basal Cell Carcinoma

Objective To evaluate the efficacy and safety of 5%Imiquimod for basal cell carcinoma.Methods We searched PubMed,Ovid,Web of Science,UMI,Elsevier,and Cochrane Library.Randomized controlled trials(RCT) comparing 5%Imiquimod versus placebo were included,two reviewers independently performed data extraction and assessed the quality.Data were entered and analyzed by RevMan 4.2.8 software supplied by the Cochrane Collaboration.Results Seven high quality trials were included.Meta-analysis of the treatment of 5%Imiquimod for superficial and nodular basal cell carcinoma showed the clinical effective rate between 5%Imiquimod and placebo were statistical differential,the former combined RR=12.66 and its 95%confidence interval was between 3.56-45.06,the latter combined RR=5.24 and its 95%confidence interval was between 2.54-10.81.No serious systematical adverse events were reported.Conclusion 5%Imiquimod is a effective and safe medicine used for treating superficial basal cell carcinoma.Dose linked with the therapeutic effect,while there is no effective difference between 5%Imiquimod applied twice daily and once daily.