Survival Benefit of Metformin as an Adjuvant Treatment for Head and Neck Cancer: A Systematic Review and Meta-Analysis.
Survival Benefit of Metformin as an Adjuvant Treatment for Head and Neck Cancer: A Systematic Review and Meta-Analysis.
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二甲双胍作为头颈癌辅助治疗的生存益处：系统评价和荟萃分析
DOI：
10.3389/fphar.2022.850750
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发表时间：
2022
影响因子：
5.6
通讯作者：
Liu, Sai
中科院分区：
文献类型：
--
作者：
Jiao, Yu;Liu, Dongjuan;Sun, Yi;Chen, Zitong;Liu, Sai
背景/目的：二甲双胍的疗效与头颈癌(HNC)患者预后的关系尚不清楚。本研究旨在通过荟萃分析阐明二甲双胍治疗的预后价值。方法：应用计算机检索Cochrane图书馆、Embase、Lilacs、MEDLINE和PubMed数据库，检索与HNC预后和二甲双胍相关的文献。Meta分析评价二甲双胍治疗与HNC总生存期(OS)、无病生存期(DFS)和疾病特异性生存期(DSS)的关系，以及物品质量、合并症、年龄、地区、吸烟是否影响二甲双胍治疗的预后。以合并危险率(HR)和95%可信区间(CI)为评价指标。结果：纳入11项符合条件的研究，涉及14,694名参与者。DFS(HR=0.67，95%CI：0.40~1.09)和DSS(HR=0.69，95%CI：0.41~1.14)对HNC患者的OS无明显影响。亚组分析显示，在NewCastle-Ottawa Scale(NOS)评分较高的研究中，二甲双胍与OS(HR=0.66，95%CI：0.49-0.88)、DFS(HR=0.49，95%CI：0.26-0.92)和DSS(HR=0.38，95%CI：0.22-0.65)改善相关。年龄亚组分析表明，年龄在65岁以下的患者(OS，HR=0.67，95%CI：0.49-0.92)更有可能受益于二甲双胍治疗。对合并症的亚组分析显示，在未经合并症调整(OS，HR=0.66，95%CI：0.51-0.85；DSS，HR=0.38，95%CI：0.22-0.65)的研究中，二甲双胍显著改善了患者的预后，但在调整了合并症的研究中并非如此。结论：二甲双胍作为一种辅助治疗改善了HNC患者的预后，尤其是对那些NOS评分较高的患者。高血压性鼻咽癌患者的年龄和合并症影响二甲双胍的疗效。还需要进一步进行良好的调查。
Background/Aims: The relationship between the efficacy of metformin and the prognosis of patients with head and neck cancer (HNC) was still unclear. This study aims to clarify the prognostic value of metformin treatment using meta-analysis. Methods: Studies related to HNC prognosis and metformin were searched in Cochrane Library, Embase, LILACS, MEDLINE and PubMed databases. A meta-analysis was performed to evaluate the association between metformin therapy and the prognosis of HNC on overall survival (OS), disease-free survival (DFS) and disease-specific survival (DSS) and whether article quality, comorbidities, age, region or smoking had an influence on the prognosis of metformin treatment. Pooled hazard ratio (HR) and 95% confidence interval (CI) were analyzed to assess the effect. Results: Eleven eligible studies involving 14,694 participants were included. Metformin increased the OS (HR = 0.87, 95% CI: 0.76–0.99), but failed on DFS (HR = 0.67, 95% CI: 0.40–1.09) or DSS (HR = 0.69, 95% CI: 0.41–1.14) in HNC patients. Subgroup analysis showed metformin was associated with improved OS (HR = 0.66, 95% CI: 0.49–0.88), DFS (HR = 0.49, 95% CI: 0.26–0.92) and DSS (HR = 0.38, 95% CI: 0.22–0.65) in studies with higher Newcastle-Ottawa Scale (NOS) scores. Subgroup analysis of age indicated that patients younger than 65 years (OS, HR = 0.67, 95% CI: 0.49–0.92) were more likely to benefit from metformin treatment. Subgroup analysis of comorbidities showed metformin significantly improved patient outcomes in studies without adjusted for comorbidities (OS, HR = 0.66, 95% CI: 0.51–0.85; DSS, HR = 0.38, 95% CI: 0.22–0.65), but not in studies that adjusted for comorbidities. Conclusions: Metformin improved the prognosis of HNC patients as an adjuvant therapy, especially in those with higher NOS scores. Age and comorbidities of HNC patients influenced the therapeutic effect of metformin. Further well-conducted investigations are needed.
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DOI：
10.1016/j.ijrobp.2015.11.007
发表时间：
2016-03-01
期刊：
International journal of radiation oncology, biology, physics
影响因子：
--
作者：
Spratt DE;Beadle BM;Zumsteg ZS;Rivera A;Skinner HD;Osborne JR;Garden AS;Lee NY
通讯作者：
Lee NY
影响因子：
4
作者：
Lo CK;Mertz D;Loeb M
通讯作者：
Loeb M
影响因子：
2.5
作者：
Tierney JF;Stewart LA;Ghersi D;Burdett S;Sydes MR
通讯作者：
Sydes MR
影响因子：
3.4
作者：
Tian, R. -H.;Zhang, Y. -G.;Ji, H. -L.
通讯作者：
Ji, H. -L.
影响因子：
4.7
作者：
Hayashino Y;Noguchi Y;Fukui T
通讯作者：
Fukui T