Systematic review of the clinical effect of glucocorticoids on nonhematologic malignancy.
Systematic review of the clinical effect of glucocorticoids on nonhematologic malignancy.
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糖皮质激素对非血液学恶性肿瘤的临床作用的系统评价。
DOI：
10.1186/1471-2407-8-84
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发表时间：
2008-03-28
期刊：
影响因子：
3.8
通讯作者：
Keith, Bruce D.
中科院分区：
文献类型：
--
作者：
Keith, Bruce D.
糖皮质激素常用于治疗非血液系统恶性肿瘤。本文综述了糖皮质激素治疗非血液系统恶性肿瘤的临床证据。对糖皮质激素治疗非血液学恶性肿瘤的临床研究进行了系统回顾。仅纳入了以肿瘤反应、肿瘤控制或生存为终点的研究。使用PubMed、EMBASE、Cochrane Register/Databases、会议论文集（ASCO、AACR、ASTRO/ASTR、ESMO、ECCO）等资源。使用标准表格提取数据。每个研究都有质量评估。有一种叙述性的信息综合，结果以表格的形式呈现。在适当的情况下，使用来自已发表报告的数据和固定效应模型进行meta分析。54项随机对照试验（RCTs）、1项荟萃分析、4项i /ll期试验和4个病例系列符合入选标准。糖皮质激素单药治疗乳腺癌和前列腺癌的临床试验显示出适度的有效率。在晚期乳腺癌荟萃分析中，在化疗或其他内分泌治疗中加入糖皮质激素可提高反应率，但不能提高生存率。在胃肠道癌症中，糖皮质激素与支持治疗和化疗+/-糖皮质激素各有一项RCT；糖皮质激素作用为中性。唯一发现化疗+/-糖皮质激素组表现更差的随机对照试验是肺癌。在糖皮质激素单药治疗中，荟萃分析发现持续高剂量糖皮质激素对生存有不利影响。唯一的其他证据，糖皮质激素单一疗法的有害影响，是在肺癌的两个试验中的一个。糖皮质激素单药治疗对乳腺癌和前列腺癌有一定疗效。在晚期乳腺癌中，在其他治疗中加入糖皮质激素不会改变长期结果。在胃肠道癌症中，糖皮质激素最有可能发挥中性作用。高剂量连续糖皮质激素对非血液学恶性肿瘤有不利影响。糖皮质激素治疗可能对肺癌有有害影响。
Glucocorticoids are often used in the treatment of nonhematologic malignancy. This review summarizes the clinical evidence of the effect of glucocorticoid therapy on nonhematologic malignancy. A systematic review of clinical studies of glucocorticoid therapy in patients with nonhematologic malignancy was undertaken. Only studies having endpoints of tumor response or tumor control or survival were included. PubMed, EMBASE, the Cochrane Register/Databases, conference proceedings (ASCO, AACR, ASTRO/ASTR, ESMO, ECCO) and other resources were used. Data was extracted using a standard form. There was quality assessment of each study. There was a narrative synthesis of information, with presentation of results in tables. Where appropriate, meta-analyses were performed using data from published reports and a fixed effect model. Fifty four randomized controlled trials (RCTs), one meta-analysis, four phase l/ll trials and four case series met the eligibility criteria. Clinical trials of glucocorticoid monotherapy in breast and prostate cancer showed modest response rates. In advanced breast cancer meta-analyses, the addition of glucocorticoids to either chemotherapy or other endocrine therapy resulted in increased response rate, but not increased survival. In GI cancer, there was one RCT each of glucocorticoids vs. supportive care and chemotherapy +/- glucocorticoids; glucocorticoid effect was neutral. The only RCT found of chemotherapy +/- glucocorticoids, in which the glucocorticoid arm did worse, was in lung cancer. In glucocorticoid monotherapy, meta-analysis found that continuous high dose glucocorticoids had a detrimental effect on survival. The only other evidence, for a detrimental effect of glucocorticoid monotherapy, was in one of the two trials in lung cancer. Glucocorticoid monotherapy has some benefit in breast and prostate cancer. In advanced breast cancer, the addition of glucocorticoids to other therapy does not change the long term outcome. In GI cancer, glucocorticoids most likely have a neutral effect. High dose continuous glucocorticoids have a detrimental effect in nonhematologic malignancy. Glucocorticoid therapy might have a deleterious impact in lung cancer.
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影响因子：
6.6
作者：
Datta, SN;Thomas, K;Matthews, PN
通讯作者：
Matthews, PN
影响因子：
45.3
作者：
Foss책, SD;Slee, PHT;Collette, L
通讯作者：
Collette, L
影响因子：
3.4
作者：
Graham, PH;Capp, A;Wirth, A
通讯作者：
Wirth, A
DOI：
10.1111/j.1365-2125.1989.tb05366.x
发表时间：
1989-03-01
影响因子：
3.4
作者：
ALHABET, SMH;ROGERS, HJ
通讯作者：
ROGERS, HJ
影响因子：
50.5
作者：
Feuer, DJ;Broadley, KE
通讯作者：
Broadley, KE