摘要
Abstract
Objective To system evaluate the third generation aromatase inhibitors ( AIs) on breast cancer.Methods Computer retrieval of Cochrane Library, PubMed, EMbase, Chinese biomedical literature database, Wanfang database, col-lected studies that met the inclusion criteria, searched from inception of database to October 2014, and also searched the re-search references and manually searched relevant meeting abstracts.According to the inclusion and exclusion criteria, 2 re-viewersindependentlyscreenedliteraturequality;Meta-analysiswascarriedoutusingRevMan5.2software.Results 11ran-domized controlled studies were enrolled, Meta-analysis results show that, compared with tamoxifen, initial AIs and sequential treatment program can significantly improve overall survival (HR=0.91, 95%CI 0.84-0.99, P =0.04;HR=0.83, 95%CI 0.73-0.95, P =0.008);disease free survival rate in AIs at the initial treatment ( HR=0.86, 95%CI 0.80-0.92, P <0.01), at sequential therapy (HR=0.72, 95%CI 0.64-0.99, P <0.01) and following intensive therapy regimen group (HR=0.62, 95%CI 0.52 -0.74, P <0.01) had improved significantly.AIs group sequential treatment regimen fracture rate was slightly higher than that of tamoxifen ( P =0.05), the other 2 treatment scheme showed no significant differ-ences from tamoxifen ( P >0.05);the incidence of endometrial carcinoma in AIs was lower than tamoxifen treatment ( P <0.01);AIs single regimen’ s thrombosis incidence was less than tamoxifen, and sequential scheme was higher than that of tamoxifen ( P <0.01); AIs single agent chemotherapy and sequential treatment’ s adverse cardiovascular events incidence was higher than that of tamoxifen ( P <0.01), and the subsequent strengthening scheme showed no significant difference from tamoxifen ( P >0.05).Conclusion AIs can bring more survival benefit than tamoxifen, and the sequential therapy seems to be more advantages than initial treatment;AIs reduces the incidence of endometrial cancer, and need to prevent ad-verse reaction such as fracture, thrombosis, cardiovascular events.关键词
芳香化酶抑制剂/乳腺癌/总生存/无病生存率/药物副作用/系统评价Key words
Aromataseinhibitors/Breastcancer/Survivalrate/Diseasefreesurvivalrate/Drugsideeffects/Systemre-view
