甘露聚糖肽对淋巴造血系统肿瘤支持治疗的Meta分析

目的:系统评价甘露聚糖肽对恶性非实体肿瘤支持治疗的有效性及安全性。方法:电子检索Cochrane图书馆、MEDLINE、EMBASE、CNKI、CBM,纳入甘露聚糖肽治疗白血病、淋巴瘤、骨髓瘤的随机、对照试验(RCT),检索日期至2011年10月。由2名研究者独立纳入试验、评价质量、提取数据并交叉核对,使用RevMan 5.0软件进行Meta分析。结果:纳入10个RCT,共有570例患者,其中治疗组320例,对照组270例,结果显示甘露聚糖肽可显著提高化疗的总有效率OR=3.9,95%CI(2.45,6.20),Z=5.75,P<0.01],亦显著提高T细胞免疫功能SMD=1.05,95%CI(0.78,1.32),Z=7.55,P<0.01],SMD=1.38,95%CI(0.64,2.13),Z=3.63,P<0.01],SMD=0.79,95%CI=(0.43,1.14),Z=4.35,P<0.01]及肿瘤患者体力状况SMD=2.34,95%CI(1.96,2.72),Z=12.09,P<0.01],同时能显著降低各种化疗引起的不良反应如白细胞计数下降SMD=0.84,95%CI(0.49,1.20),Z=4.63,P<0.01],减少白细胞计数最低值持续时间SMD=-1.19,95%CI(-1.56,-0.82),Z=6.30,P<0.01]等,治疗过程中可引起轻微发热、皮疹。结论:甘露聚糖肽可提高实体肿瘤化疗的近期疗效,减轻不良反应,改善生活质量。但由于纳入研究的方法质量尚待提高,上述结论有待进一步开展大样本、高质量、多中心的随机、双盲、对照试验来证实。

Meta-analysis of Mannatide Injection as Supportive Therapy for Lymphohaemopoietic Tumor

OBJECTIVE: To evaluate the efficacy and safety of Mannatide injection in the supportive treatment of lymphohaemopoietic tumor.METHODS: The randomized controlled trials(RCT) on Mannatide injection in the treatment of leukemia,lymphoma and myeloma(up to Oct.2011) were retrieved from Medline,EMBASE,Cochrane Library,CBM,VIP,and CNKI databases.Inclusion of RCT,quality evaluation,data collection and cross-check were performed by two researchers independently.Meta-analysis was performed using RevMan 5.0 software.RESULTS: A total of 10 RCT including 570 patients(320 in the treatment group and 270 in the control group) were included in the meta-analysis.The results show that Mannatide significantly improved the total effective rate of chemotherapy OR=3.9,95%CI(2.45,6.20),Z=5.75,P<0.01],enhanced the immunologic function of T cells SMD=1.05,95%CI(0.78,1.32),Z=7.55,P<0.01],SMD=1.38,95%CI(0.64,2.13),Z=3.63,P<0.01],SMD=0.79,95%CI(0.43,1.14),Z=4.35,P<0.01],improved tumor patients’ physical strength(Karnofsky scale) SMD=2.34,95%CI(1.96,2.72),Z=12.09,P<0.01],signficantly attenuated the reduction of white blood count(WBC) that caused by differnent chemotherapy SMD=0.84,95%CI(0.49,1.20),Z=4.63,P<0.01] and reduced the duration of lowest WBC SMD=-1.19,95%CI(-1.56,-0.82),Z=6.30,P<0.01].The main adverse reactions of Mannatide included mild fever and rash.CONCLUSION: Treatment of patients with solid tumor using Mannatide improved the short-term efficacy of chemotherapy,attenuated side effects and improved patients’ quality of life.However,the quality of the methodology for the included studies is far from perfect,thus the above conclusion awaits further validation in future high quality,multicenter,large-scale,randomized double-blind controlled trials.