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目的系统评价帕妥珠单抗治疗癌症的皮疹发生率及其发生风险。方法计算机检索The Cochrane Library、PubMed、EMbase、CBM、CNKI、VIP和WanFang Data数据库,收集帕妥珠单抗治疗癌症并报告皮疹发生率或其发生风险的临床试验,检索时限均从建库至2013-11-20日。由2位为评价员根据纳入与排除标准独立进行文献筛选、资料提取及质量评价后,采用CMA v2.0软件进行Meta分析。结果最终共纳入8个研究,共1726例患者。Meta分析结果显示:帕妥珠单抗治疗癌症的皮疹发生率为24.6%(95%CI:19.3%~30.8%,P<0.001);帕妥珠单抗治疗癌症的高级别(3/4级)皮疹发生率为1.3%(95%CI:0.6%~3.2%,P<0.001);帕妥珠单抗治疗癌症的皮疹发生风险为1.61倍(RR=1.61,95%CI:1.01~2.57,P=0.047)。亚组分析显示,帕妥珠单抗治疗前列腺癌皮疹发生率为13.2%(95%CI:7.9%~21.2%,P<0.001),较其他癌症低。结论帕妥珠单抗治疗癌症可能引起皮疹,且不同的癌症类型皮疹发生率不同。提示在应用帕妥珠单抗治疗癌症病人时,应早期发现、早期适当治疗、最优化治疗,减少病人的负担。
Objective To systematically evaluate the incidence and risk of rash in the treatment of pertuzumab. Methods The computer-aided search of The Cochrane Library, PubMed, EMbase, CBM, CNKI, VIP and WanFang Data databases collected pertuzumab in the treatment of cancer and report the incidence of rash or the risk of clinical trials, search time from building to 2013 - 11-20 days. According to the inclusion and exclusion criteria, two reviewers independently selected the documents for screening, data extraction and quality evaluation, and then used CMA v2.0 software for meta-analysis. Results A total of 8 studies were included, altogether 1726 patients. Meta-analysis showed that the incidence of rash of pertuzumab in the treatment of cancer was 24.6% (95% CI: 19.3% -30.8%, P <0.001); the high-grade (3/4 ) Rash was 1.3% (95% CI: 0.6% -3.2%, P <0.001); the risk of rash with pertuzumab was 1.61 times (RR = 1.61, 95% CI: 1.01-2.57, P = 0.047). Subgroup analyzes showed that the incidence of rash in the treatment of prostate cancer by pertuzumab was 13.2% (95% CI: 7.9% -21.2%, P <0.001), which was lower than other cancers. Conclusion Pertuzumab treatment of cancer may cause rash, and different types of cancer rash different rates. Tip in the application of pertuzumab treatment of cancer patients, should be early detection, early appropriate treatment, optimal treatment, reduce the burden on patients.