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芳香化酶抑制剂用于绝经后激素受体阳性早期乳腺癌有效性及安全性的网状Meta分析
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| 篇名： | 芳香化酶抑制剂用于绝经后激素受体阳性早期乳腺癌有效性及安全性的网状Meta分析 |
| TITLE： | Network meta-analysis for efficacy and safety of aromatase inhibitors for postmenopausal hormone receptor-positive early breast cancer |
| 摘要： | 目的 评价3种芳香化酶抑制剂（依西美坦、阿那曲唑、来曲唑）用于绝经后激素受体（HR）阳性早期乳腺癌的有效性及安全性。方法检索PubMed、theCochraneLibrary、Embase、中国知网、万方数据、维普网、中国生物医学文献数据库，收集上述3种药物治疗绝经后HR阳性早期乳腺癌患者的随机对照试验（RCT），检索时限为建库至2024年10月25日。筛选文献、提取资料、评价文献质量后，采用RevMan5.3和Stata18.0软件进行网状Meta分析。结果共纳入15项RCT，共计44055例患者。网状Meta分析结果显示，来曲唑组患者的客观缓解率显著高于阿那曲唑组（P＜0.05），其累积排序概率曲线下面积（SUCRA）由高到低依次为来曲唑（85.6%）＞阿那曲唑（61.5%）＞依西美坦（2.8%）；阿那曲唑组患者的无病生存率显著高于依西美坦组和安慰剂组（P＜0.05），其SUCRA由高到低排序为来曲唑（85.8%）＞阿那曲唑（67.3%）＞依西美坦（41.4%）＞安慰剂（5.5%）。阿那曲唑组患者的不良反应总发生率显著高于来曲唑组和安慰剂组（P＜0.05），其SUCRA由高到低排序依次为依西美坦（87.4%）＞来曲唑（63.9%）＞阿那曲唑（47.0%）＞安慰剂（1.7%）；按疗程≥104周进行的亚组分析结果与之一致。结论与阿那曲唑比较，来曲唑治疗绝经后HR阳性早期乳腺癌的有效性和安全性均较好，而依西美坦的疗效有限。 |
| ABSTRACT： | OBJECTIVE To evaluate the efficacy and safety of three aromatase inhibitors （exemestane， anastrozole， letrozole） for postmenopausal hormone receptor （HR）-positive early breast cancer. METHODS PubMed， the Cochrane Library， Embase， CNKI， Wanfang Data， VIP and SinoMed were searched to collect randomized controlled trials （RCTs） of the above three drugs in the treatment of postmenopausal HR-positive early breast cancer patients. The retrieval time limit was from the establishment of the database to October 25， 2024. After literature screening， data extraction and literature quality evaluation， network meta-analysis was performed by using RevMan 5.3 and Stata 18.0 software. RESULTS A total of 15 RCTs involving 44 055 patients were included. The results of network meta-analysis showed that the objective response rate of letrozole group was significantly higher than anastrozole group （P＜0.05）， and the order of surface under the cumulative ranking curve （SUCRA） from high to low was letrozole （85.6%）＞anastrozole （61.5%）＞exemestane （2.8%）. The disease-free survival rate of anastrozole group was significantly higher than exemestane and placebo groups （P＜0.05）， and the order of SUCRA from high to low was letrozole （85.8%）＞ anastrozole （67.3%）＞exemestane （41.4%）＞placebo （5.5%）. The total incidence of adverse reactions in anastrozole group was significantly higher than letrozole and placebo groups （P＜0.05）， and the order of SUCRA from high to low was exemestane （87.4%）＞letrozole （63.9%）＞anastrozole （47.0%）＞placebo （1.7%）. The results of subgroup analysis according to the course of treatment≥104 weeks were consistent with them. CONCLUSIONS Compared with anastrozole， letrozole has better efficacy and safety in the treatment of postmenopausal HR-positive early breast cancer， and the efficacy of exemestane is limited. |
| 期刊： | 2025年第36卷第12期 |
| 作者： | 栗玉杰；张文静；杨宏昕；郭浩 |
| AUTHORS： | LI Yujie，ZHANG Wenjing，YANG Hongxin，GUO Hao |
| 关键字： | 芳香化酶抑制剂；依西美坦；阿那曲唑；来曲唑；绝经后早期乳腺癌；激素受体阳性；内分泌治疗 |
| KEYWORDS： | aromatase inhibitors； exemestane； anastrozole； |
| 阅读数： | 7 次 |
| 本月下载数： | 1 次 |
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