PDF(Pubmed)
Abstract：
We aimed to summarize the cancer risk among patients with indication of group I pharmaceuticals as stated in monographs presented by the International Agency for Research on Cancer working groups. Following the PRISMA guidelines, a comprehensive literature search was conducted using the PubMed database. Pharmaceuticals with few studies on cancer risk were identified in systematic reviews; those with two or more studies were subjected to meta-analysis. For the meta-analysis, a random-effects model was used to calculate the summary relative risks (SRRs) and 95% confidence intervals (95% CIs). Heterogeneity across studies was presented using the Higgins I square value from Cochran\'s Q test. Among the 12 group I pharmaceuticals selected, three involved a single study [etoposide, thiotepa, and mustargen + oncovin + procarbazine + prednisone (MOPP)], seven had two or more studies [busulfan, cyclosporine, azathioprine, cyclophosphamide, methoxsalen + ultraviolet (UV) radiation therapy, melphalan, and chlorambucil], and two did not have any studies [etoposide + bleomycin + cisplatin and treosulfan]. Cyclosporine and azathioprine reported increased skin cancer risk (SRR = 1.32, 95% CI 1.07-1.62; SRR = 1.56, 95% CI 1.25-1.93) compared to non-use. Cyclophosphamide increased bladder and hematologic cancer risk (SRR = 2.87, 95% CI 1.32-6.23; SRR = 2.43, 95% CI 1.65-3.58). Busulfan increased hematologic cancer risk (SRR = 6.71, 95% CI 2.49-18.08); melphalan was associated with hematologic cancer (SRR = 4.43, 95% CI 1.30-15.15). In the systematic review, methoxsalen + UV and MOPP were associated with an increased risk of skin and lung cancer, respectively. Our results can enhance persistent surveillance of group I pharmaceutical use, establish novel clinical strategies for patients with indications, and provide evidence for re-categorizing current group I pharmaceuticals into other groups.
摘要：
我们旨在总结国际癌症研究机构工作组发表的专著中所述的具有I组药物适应症的患者的癌症风险。按照PRISMA准则，使用PubMed数据库进行了全面的文献检索.在系统评价中确定了对癌症风险研究很少的药物；那些有两项或更多研究的药物进行了荟萃分析。对于荟萃分析，使用随机效应模型计算总相对风险(SRR)和95%置信区间(95%CIs).使用来自Cochran的Q检验的HigginsI平方值表示研究之间的异质性。在选择的12组I药物中，三个涉及一项研究[依托泊苷，Thiotepa,和芥末+癌+丙卡巴嗪+泼尼松(MOPP)]，七个人进行了两项或多项研究[白消安，环孢菌素,硫唑嘌呤，环磷酰胺,甲氧沙林+紫外线（UV）放射治疗，melphalan,和苯丁酸氮芥]，和两个没有任何研究[依托泊苷+博来霉素+顺铂和曲硫丹]。环孢菌素和硫唑嘌呤报告与不使用相比，皮肤癌风险增加（SRR=1.32，95％CI1.07-1.62；SRR=1.56，95％CI1.25-1.93）。环磷酰胺增加了膀胱和血液系统癌症的风险（SRR=2.87，95％CI1.32-6.23；SRR=2.43，95％CI1.65-3.58）。白消安增加血液系统癌症风险（SRR=6.71，95％CI2.49-18.08）；美法仑与血液系统癌症相关（SRR=4.43，95％CI1.30-15.15）。在系统审查中，甲氧沙林+紫外线和MOPP与皮肤癌和肺癌的风险增加有关，分别。我们的结果可以加强对第一组药物使用的持续监测，为有适应症的患者建立新的临床策略，并为将目前的I组药物重新分类为其他组提供证据。
