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目的评价多柔比星和表柔比星应用于转移性乳腺癌的疗效和安全性。方法检索Cochrane图书馆、Pub Med、Embase、CNKI、CBM和万方期刊数据库,筛选相关文献,对符合纳入标准的文献进行资料提取和质量评价,采用Meta分析和描述统计分析。结果最终纳入6篇研究。总生存期分析结果表示,多柔比星和表柔比星的总生存期效应相似(549 d和480 d)。客观缓解率Meta分析结果显示,多柔比星治疗转移性乳腺癌的疗效与表柔比星相当[RR=1.12,95%CI(0.99,1.26),P=0.07]。不良反应分析表明,表柔比星的血液学毒性和脱发的发生率与多柔比星相当,但表柔比星的心脏毒性低于多柔比星。结论多柔比星和表柔比星均能有效治疗转移性乳腺癌,但多柔比星的心脏毒性高于表柔比星,不建议用于患有心脏疾病的转移性乳腺癌患者。
Objective To evaluate the efficacy and safety of doxorubicin and epirubicin in metastatic breast cancer. METHODS: The Cochrane Library, Pub Med, Embase, CNKI, CBM, and Wanfang periodical databases were searched, relevant literature was screened, data extraction and quality evaluation were performed on the documents that met the inclusion criteria, and Meta analysis and descriptive statistical analysis were used. The results eventually included 6 studies. The results of the overall survival analysis showed that the overall survival effects of doxorubicin and epirubicin were similar (549 d and 480 d). The meta-analysis of objective response rates showed that doxorubicin was associated with comparable efficacy with epirubicin in the treatment of metastatic breast cancer [RR=1.12, 95%CI(0.99, 1.26), P=0.07]. Adverse reaction analysis showed that the incidence of hematologic toxicity and hair loss in epirubicin was comparable to that of doxorubicin, but that of epirubicin was lower than that of doxorubicin. Conclusion Both doxorubicin and epirubicin can effectively treat metastatic breast cancer, but doxorubicin has higher cardiotoxicity than epirubicin and is not recommended for metastatic breast cancer patients with heart disease.