目的:本系统综述和荟萃分析旨在评估现有文献描述天然和其他药物在预防癌症患者急性放射性皮炎(RD)中的疗效。
方法:OVIDMedLine,Embase,从1946年至2023年1月检索了Cochrane文献数据库,用于研究使用天然药物和其他药物预防RD的随机对照试验.RevMan5.4用于荟萃分析,使用随机效应分析计算合并效应大小和95%置信区间(CI)。
结果:对于系统评价和荟萃分析,包括19和16项研究,分别。在所研究的五种天然产物中(芦荟,口服酶,橄榄油,金盏花,和姜黄素),仅口服酶和橄榄油显着降低放疗肿瘤学组2级+的发生率(RR:0.42,95CI0.30-0.58,p<0.00001,RR:0.66,95%CI0.51-0.85,p=0.001,resp.).口服酶也降低了3级+RD的发生率(RR:0.18,95CI0.06-0.55,p=0.003)。其他药剂没有显示出显著的效果。
结论:这项关于天然和其他药物预防癌症患者RD的综述和荟萃分析显示,口服酶和橄榄油可预防RD严重程度。然而,支持自然因子预防RD的证据不一致,主要是因为研究数量少,低质量的研究设计,和小样本量。因此,无法得出具体结论。对(新的)天然或其他药物的研究应集中在具有大量患者人群的随机对照双盲研究设计上,研究方法的一致性更高,以及临床和患者报告的结果。
OBJECTIVE: This systematic review and meta-analysis aimed to evaluate the available literature describing the efficacy of natural and miscellaneous agents in preventing acute radiation dermatitis (RD) in cancer patients.
METHODS: OVID MedLine, Embase, and Cochrane literature databases were searched from 1946 to January 2023 for randomized controlled trials studying the use of natural and miscellaneous agents to prevent RD. RevMan 5.4 was used for the meta-analysis to calculate the pooled effect sizes and 95% confidence intervals (CI) using the random effects analysis.
RESULTS: For the systematic review and meta-analysis, 19 and 16 studies were included, respectively. Of the five studied natural products (aloe vera, oral enzymes, olive oil, calendula, and curcumin), only oral enzymes and olive oil significantly reduced the incidence of Radiation Therapy Oncology Group grade 2+ (RR: 0.42, 95%CI 0.30-0.58, p < 0.00001, RR: 0.66, 95% CI 0.51-0.85, p = 0.001, resp.). The oral enzymes also reduced the grade 3+ RD incidence (RR: 0.18, 95%CI 0.06-0.55, p = 0.003). The other agents demonstrated no significant effect.
CONCLUSIONS: This review and meta-analysis on natural and miscellaneous agents in preventing RD in cancer patients demonstrated that oral enzymes and olive oil prevented RD severity. However, evidence supporting natural agents to prevent RD is inconsistent, mainly because of low studies numbers, low-quality study designs, and small sample sizes. Therefore, concrete conclusions cannot be made. Research on (new) natural or miscellaneous agents should focus on a randomized controlled double-blinded study design with a large patient population, a higher consistency in research methods, and clinician- and patient-reported outcomes.