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目的对雷帕霉素靶蛋白(mTOR)抑制剂辅助治疗乳腺癌患者的疗效及风险进行评价,从而对临床治疗乳腺癌提供指导。方法应用PubMed、MEDLINE、EMBASE和Cochrane电子数据库搜索mTOR抑制剂用于治疗乳腺癌患者的随机对照临床试验,不设置限制日期。按Cochrane系统评价法提取所需资料,采用RevMan 5.2进行Meta分析。结果 4项临床试验(共11篇文献)被纳入本Meta分析。与对照组比较,联用mTOR抑制剂的实验组患者无进展生存期(progression-free survival,PFS)显著延长(P<0.05),疾病进展(progressive disease,PD)显著减少(P<0.01)。但不良事件的发生率也显著增加(P<0.05)。两组间总生存期(overall survival,OS)、完全缓解率(complete response,CR)和部分缓解率(partial response,PR)比较差异无统计学意义。结论mTOR抑制剂对乳腺癌患者特别是进展期或耐药型乳腺癌患者有临床疗效,但增加了辅助治疗药物在乳腺癌患者中的毒性反应。
Objective To evaluate the efficacy and risk of adjuvant therapy with rapamycin target protein (mTOR) in patients with breast cancer, so as to provide guidance for the clinical treatment of breast cancer. Methods PubMed, MEDLINE, EMBASE and Cochrane electronic databases were searched for randomized controlled clinical trials of mTOR inhibitors for breast cancer patients without setting a limit date. According to the Cochrane systematic review, the data were extracted and Meta-analysis was performed using RevMan 5.2. Results Four clinical trials (11 articles) were included in this meta-analysis. Compared with the control group, the progression-free survival (PFS) and the progressive disease (PD) in the experimental group were significantly prolonged (P <0.01). However, the incidence of adverse events also increased significantly (P <0.05). There was no significant difference in overall survival (OS), complete response (CR) and partial response (PR) between the two groups. Conclusions The mTOR inhibitor has a clinical effect on patients with breast cancer, especially in patients with advanced or resistant breast cancer, but increases the toxicity of adjuvant therapy in patients with breast cancer.