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卵巢上皮癌术后化疗指南/共识的循证研究
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| 篇名： | 卵巢上皮癌术后化疗指南/共识的循证研究 |
| TITLE： | Evidence-based study on postoperative chemotherapy guidelines/consensuses for ovarian epithelial tumor |
| 摘要： | 目的 系统评价卵巢上皮癌术后化疗指南/共识的方法学质量。方法检索PubMed、Embase、WebofScience、中国生物医学文献数据库、维普网、中华医学期刊全文数据库、万方数据和中国知网，以及GIN、NICE、医脉通、AHRQ、CSCO、ASCO、NCCN等官网，检索时限为建库/建站至2025年3月10日。使用临床指南研究与评价系统Ⅱ（AGREE-Ⅱ）对纳入指南/共识的质量进行评价。结果共纳入指南/共识16篇。AGREE-Ⅱ评价的各领域得分分别为：范围和目的85.07%、参与人员47.92%、严谨性57.49%、清晰性88.02%、应用性8.20%和独立性53.39%。其中，14篇的推荐等级为B级，2篇为C级。按不同国家/地区、不同研究类型的亚组分析结果显示，我国指南/共识的参与人员、严谨性、独立性得分均显著低于国外（P＜0.05）；指南的参与人员、严谨性得分均显著高于共识（P＜0.05）。指南/共识推荐意见结果显示，B级指南/共识推荐铂类药物为基础的联合化疗为Ⅰ期高级别浆液性癌患者的首选辅助化疗方案；推荐铂类药物为基础的联合化疗±贝伐珠单抗为Ⅱ～Ⅳ期高级别浆液性癌患者辅助化疗以及铂敏感复发性高级别浆液性癌患者化疗的首选方案；推荐非铂类药物单药±贝伐珠单抗为铂耐药复发性高级别浆液性癌患者化疗的首选方案。结论卵巢上皮癌术后化疗的指南/共识总体质量不高；我国指南/共识的方法学质量相较于国外尚有差距，推荐意见与国外存在差异。建议完善参与人员、严谨性和独立性领域，根据卵巢癌的不同分期特点推荐治疗方案，制定符合我国国情的指南/共识。 |
| ABSTRACT： | OBJECTIVE To systematically evaluate the methodological quality of the postoperative chemotherapy guidelines/ consensuses for ovarian epithelial tumor. METHODS A search was conducted across databases including PubMed， Embase， Web of Science， CBM， VIP， Chinese Medical Journal Data， Wanfang Data， and CNKI， as well as the official websites of GIN， NICE， Medlive， AHRQ， CSCO， ASCO， and NCCN. The search period was from the establishment of the databases/websites to March 10， 2025. The quality of the included guidelines/consensus was evaluated by using the AGREE-Ⅱ tool. RESULTS A total of 16 guidelines/consensuses were included. The domain scores of AGREE-Ⅱ evaluation were as follows： scope and purpose of 85.07%， participants of 47.92%， rigor of development of 57.49%， clarity of presentation of 88.02%， applicability of 8.20%， and independence of 53.39%. Among them， 14 were recommended at grade B and 2 were recommended at grade C. The subgroup analysis by different countries/regions and different types of studies showed that the scores for participants， rigor of development， and independence of the guidelines/consensuses in China were significantly lower than foreign countries （P＜0.05）； the scores for participants and rigor of development of the guidelines were significantly higher than consensuses （P＜0.05）. The guideline/ consensus recommendation results indicated that grade B guidelines/consensus recommend platinum-based combination chemotherapy as the preferred adjuvant chemotherapy regimen for stage Ⅰ high-grade serous carcinoma patients；platinum-based combination chemotherapy±bevacizumab was recommended as the preferred adjuvant chemotherapy regimen for stage Ⅱ-Ⅳ high- grade serous carcinoma patients and for platinum-sensitive recurrent high-grade serous carcinoma patients； non-platinum single- agent chemotherapy±bevacizumab was recommended as the preferred chemotherapy regimen for platinum-resistant recurrent high- grade serous carcinoma patients. CONCLUSIONS The overall quality of postoperative chemotherapy guidelines/consensuses for ovarian epithelial tumor is not high. The methodological quality of guidelines/consensuses in China is still lagging behind that of foreign countries. The recommendations differ from those in foreign countries. It is recommended to improve the aspects of participants， rigor of development， and independence， to recommend treatment plans based on the different stages of ovarian cancer， and develop guidelines/consensuses that align with China’s national conditions. |
| 期刊： | 2025年第36卷第18期 |
| 作者： | 罗鲜丹；陆艳丽；吴亦航；郭雁翔；颜潇旖；霍勇超；严辉；杨镇江；张宏亮 |
| AUTHORS： | LUO Xiandan，LU Yanli， WU Yihang，GUO Yanxiang，YAN Xiaoyi，HUO Yongchao，YAN Hui，YANG Zhenjiang，ZHANG Hongliang |
| 关键字： | 卵巢上皮癌；AGREE-Ⅱ；指南；共识；循证评价 |
| KEYWORDS： | ovarian epithelial tumor； AGREE-Ⅱ； guideline； consensus； evidence-based evaluation |
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