在癌症患者中预防手脚综合征:系统性审查和网络元分析
Hemavathi Baskarane1, Shubham Sahni1, Chitrakshi Nagpal1
1Department of Medical Oncology, All India Institute of Medical Sciences, New Delhi, India.
JAMA dermatology
|March 4, 2026
概括
迪克洛菲纳克和西利马林在预防化疗诱导的手脚综合征 (HFS) 中是有效的. 迪克洛菲纳克显示了最好的证据,而西利马林需要进一步研究. 这些发现为管理这种常见的副作用提供了新的希望.
科学领域:
- 在瘤学瘤学.
- 药理学 药理学是指药理学的学科.
- 临床试验 临床试验
背景情况:
- 手脚综合征 (HFS) 是常见的,限制化疗剂量的毒性,影响患者的生活质量和治疗效果.
- 目前对化疗引起的HFS的预防策略有限,需要对有效干预措施的研究.
研究的目的:
- 进行网络元分析,比较各种药物干预措施的疗效,以预防化疗诱导的HFS.
- 根据已发表的随机临床试验 (RCT) 数据,确定用于HFS预防的最有效药物.
主要方法:
- 对PubMed,Embase和Cochrane CENTRAL进行系统的文献搜索,以获得关于HFS预防的2/3期RCT.
- 19个RCT (2192名患者) 的频率随机效应网络元分析,评估系统性或局部性预防干预措施.
- 主要结果:第2级或更高HFS的发生率;次要结果:任何级别的HFS的发生率. 使用P分数和SUCRA值进行排名分析.
主要成果:
- 与安慰剂相比,局部使用的西利马林,迪克洛菲纳克,400毫克的皮里多克辛和赛莱科西布显著降低了2级或更高级别的HFS.
- 迪克洛菲纳克和赛莱科西布也降低了HFS的总体发病率.
- 西利玛林和迪克洛芬雅克在疗效方面表现出最高的排名 (SUCRA值分别为0.91和0.76).
结论:
- 迪克洛菲纳克和西利马林是预防化疗诱导的HFS最有前途的药理学策略.
- 狄克洛菲纳克提供了最强有力的证据基础,结合了疗效和研究质量.
- 建议进行进一步的大规模随机试验,以确认西利玛林的疗效.
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