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Lancet:早期乳腺癌不同化疗方案疗效的比较:123项随机试验中100000名妇女长期结局的荟萃分析

2012-03-10 Wang YC,Clarke M,Taylor C,et al. MedSci原创

本研究对随机试验中病人的数据进行了荟萃分析,这些试验包括:任何以紫杉类联合蒽环类方案 vs. 相同的或联合更多的非紫杉类化疗进行比较的试验(n = 44000);一项蒽环类方案 vs.另一项蒽环类方案(n=7000)或者 vs.环磷酰胺、甲氨蝶呤、氟尿嘧啶方案(CMF方案;N=18000)进行比较的试验;多重化疗 vs.非化疗进行比较的试验(n=32000)。这三种药物及蒽环类药物阿霉素(A)和表

本研究对随机试验中病人的数据进行了荟萃分析,这些试验包括:任何以紫杉类联合蒽环类方案 vs. 相同的或联合更多的非紫杉类化疗进行比较的试验(n = 44000);一项蒽环类方案 vs.另一项蒽环类方案(n=7000)或者 vs.环磷酰胺、甲氨蝶呤、氟尿嘧啶方案(CMF方案;N=18000)进行比较的试验;多重化疗 vs.非化疗进行比较的试验(n=32000)。这三种药物及蒽环类药物阿霉素(A)和表阿霉素(E)的用药剂量被用来确定标准的CMF、4AC、CAF和CEF。研究报告了对数秩乳腺癌死亡率比(RRs)。 在蒽环类为基础的对照治疗方案上,增加4个独立周期的紫杉类治疗,延长治疗时间,可以降低乳腺癌死亡率(RR 0.86, SE 0.04,双侧检验[2p]=0.0005)。在加用四个周期紫杉类的试验组与加用其他细胞毒性药物(大约两倍的非紫杉类剂量)的对照组进行比较的试验中,没有显著差异(RR 0.94,SE 0.06,2p=0.33)。以CMF治疗作为对照的试验表明,标准的4AC和标准的CMF治疗方案是等效的(RR 0.98,SE 0.05,2p=0.67),但累积剂量大大高于标准4AC

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    2012-11-03 howi
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