Effectiveness and Safety of Radiosensitizer Metronidazole Amino Acidum Natrium for Esophagus Carcinoma: A Meta-Analysis_Chinese Journal of Evidence-Based Medicine

Authors：

MI Denghai ^1,2,3 , REN Weiwei ^1,2 , TIAN Jinhui ¹ , LI Zheng ^1,2 ,  YANG Kehu ^1,2 , XU Song ²

1. Evidence-Based Medicine Center, Lanzhou University, Lanzhou 730000, China;2. The First Clinical Medicine College, Lanzhou University, Lanzhou 730000, China;3. Gansu Provincial Second People’s Hospital, Lanzhou 730000, China;

Corresponding author：

YANG Kehu, Email: yangkh@lzu.edu.cn

Keywords：

Esophagus carcinoma; Metronidazole amino acidum natrium; Radiotherapy; Radiosensitizer; Meta-analysis; Randomized controlled trial

DOI：

10.7507/1672-2531.20120175

Video：

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Objective 　To evaluate the effectiveness and safety of radiosensitizer metronidazole amino acidum natrium (CMNa) for esophagus carcinoma.
Methods 　Databases including The Cochrane library, PubMed, EMbase, CBM, CNKI, VIP and WanFang Data were searched from their establishment dates to Feb. 1st 2012 for randomized controlled trials (RCTs) of CMMa for esophagus carcinoma. Two reviewers independently screened literature and assessed the quality of the included studies and extracted data. Meta-analysis waw conducted using RevMan 5.1 software.
Results 　A total of 17 RCTs involving 1 475 patients met the inclusion criteria. Results of meta-analyses showed that: a) As for short-term response, the total effectiveness of the experimental group given CMNa plus radiotherapy was higher than the control group given radiotherapy alone (OR=3.51, 95%CI 2.44 to 5.07, P lt;0.000 01). b) Significant differences were found in the quality of life, and one and two year survival rates (OR=2.90, 95%CI 1.91 to 4.39, P lt;0.000 01; OR=1.95, 95%CI 1.21 to 3.15, P=0.006). In accordance with the P-value of 0.05, there was a significant difference in three-year survival rate (OR=2.28, 95%CI 1.16 to 4.49, P=0.02). c) As for safety, no significant differences were found in radiation pneumonitis, radiation esophagitis, myelosuppression and mucous membrane reactions.
Conclusion 　CMNa plus radiotherapy has beneficial effects in the treatment of esophagus carcinoma and improves 1, 2 and 3-year survival rates, but more RCTs on the quality of life and safety evaluation are needed.

Citation： MI Denghai,REN Weiwei,TIAN Jinhui,LI Zheng,YANG Kehu,XU Song. Effectiveness and Safety of Radiosensitizer Metronidazole Amino Acidum Natrium for Esophagus Carcinoma: A Meta-Analysis. Chinese Journal of Evidence-Based Medicine, 2012, 12(9): 1122-1128. doi: 10.7507/1672-2531.20120175 Copy

1.	Koizumih A, Minamid J. Prognosis of patients with advanced carcinoma of the esophagus with complete response to chemotherapy and/or radiation therapy: a questionaire survey in Japan. Clin Oncol, 2001, 6(3): 132-137.
2.	Wouters BG, Wepper SA, Koritzinsky M, et al. Hypoxia as target for combined modality treatment. Eur J Cancer, 2002, 38(2): 240-257.
3.	Brown JM. Tumor hypoxia in cancer therapy. Methods Enzymol, 2007, 435: 297-321.
4.	Overgaard J. Hypoxic radiosensitization: adored and ignored. J Clin Oncol, 2007, 25: 4066-4074.
5.	侯如蓉, 翟光胜, 李文辉, 等. 放射增敏剂的研究进展. 中国辐射卫生, 2007, 16(4): 507-508.
6.	吴珊, 孙国平, 权循凤, 等. 食管癌根治性放射治疗联合放射增敏剂研究文献分析. 安徽医学, 2011, 32(7): 882-885.
7.	彭俊英, 吴金通, 沈芬, 等. 甘氨双唑钠(CMNa)对食管癌放射治疗增敏作用的临床观察. 海峡药学, 2011, 23(5): 164-165.
8.	孙菁, 王凤英, 高红军, 等. 甘氨双唑钠(CMNa)对食管癌放射治疗增敏作用的研究. 现代肿瘤医学, 2004, 12(5): 397-399.
9.	孙桂丽, 任志红, 韩忠发.甘氨双唑钠(CMNa)对食管癌放射治疗增敏作用的临床观察. 内蒙古民族大学学报(自然科学版), 2007, 22(6): 665-666.
10.	李喜茹, 冯建军, 韩宪春, 等. 甘氨双唑钠对Ⅲ和Ⅳ期食管癌患者放射增敏作用及不良反应观察. 中国药物与临床, 2010, 10(11): 1280-1281.
11.	蔡述华, 王捷忠, 林建辉, 等. 甘氨双唑钠对老年食管癌放射治疗增敏作用的临床分析. 福建医药杂志, 2009, 31(2): 128-129.
12.	陆雁. 甘氨双唑钠对食道癌放射治疗增敏作用的疗效观察及护理. 现代护理, 2008, 14(4): 516-517.
13.	蔡白振, 孔飞, 陈显钊. 甘氨双唑钠对食道癌放射治疗增敏作用的研究. 中国热带医学, 2008, 8(3): 416-417.
14.	侯良宝, 刘彦中, 李红霞, 等. 甘氨双唑钠对食管癌的放射增敏作用. 实用肿瘤学杂志, 2007, 21(5): 451-452.
15.	王明智, 吴伟, 吴刚, 等. 甘氨双唑钠对食管癌放疗增敏作用的临床观察. 中国现代医药杂志, 2011, 13(10): 63-65.
16.	钟小鹏, 白力, 邹文蕙, 等. 甘氨双唑钠对食管癌放射增敏作用的临床应用. 医药论坛杂志, 2008, 29(2): 58-61.
17.	赵永生, 辛芳, 赵娜, 等. 甘氨双唑钠对食管癌放射治疗增敏作用的临床研究. 中华现代临床医学杂志, 2007, 5(7): 607-608.
18.	李瑞锋, 胡燕华, 李艾恩, 等. 甘氨双唑钠对食管癌放射治疗增敏作用的研究. 福建医药杂志, 2005, 27(1): 76-77.
19.	程惠华, 傅志超, 林贵山, 等. 甘氨双唑钠对食管癌根治性放疗后复发再程放疗的增敏作用, 第四军医大学学报, 2007, 28(1): 39-41.
20.	朱蓉, 唐世芳, 李彩云, 等. 甘氨双唑钠对中晚期食管癌放射增敏作用的疗效观察与护理. 安徽医学, 2010, 31(8): 995-996.
21.	金红梅. 三维适形放射治疗食管癌联合希美钠增敏70例临床观察. 齐齐哈尔医学院学报, 2010, 31(14): 2232.
22.	叶永来, 田智峰, 王素青. 食管癌后程加速超分割放疗加甘氨双唑钠增敏的临床研究. 现代中西医结合杂志, 2006, 15(10): 1285-1286.
23.	高飞, 赵莺, 尹小祥, 等. 食管癌后程加速超分割放疗加甘氨双唑钠增敏的临床研究. 临床肿瘤学杂志, 2007, 12(7): 514-516.
24.	陆嘉德, Lee K, Hai M. 局部中晚期食管癌的多学科整合治疗. 中国癌症杂志, 2008, 18(5): 333-338.
25.	van den Bogaert W, van der Schueren E, Horiot JC, et al. The EORTC randomized trial on three fractions per day and misonidazole (trial no 22811) in advanced head and neck cancer: long-term results and side effects. Radiotherapy and Oncol, 1995, 35(2): 91-99.
26.	Lee DJ, Trotti A, Spencer S, et al. Concurrent tirapazamine and radiotherapy for advanced head and neck carcinomas: a phaseⅡstud. Int J Radiat Oncol Biol Phys, 1998, 42(4): 811-815.
27.	李迎春, 李宏斌, 陈成宏, 等. 甘氨双唑钠配合放疗治疗食管癌术后复发的近期疗效观察. 现代医药卫生, 2009, 25(11): 1608-1609.

1. Koizumih A, Minamid J. Prognosis of patients with advanced carcinoma of the esophagus with complete response to chemotherapy and/or radiation therapy: a questionaire survey in Japan. Clin Oncol, 2001, 6(3): 132-137.
2. Wouters BG, Wepper SA, Koritzinsky M, et al. Hypoxia as target for combined modality treatment. Eur J Cancer, 2002, 38(2): 240-257.
3. Brown JM. Tumor hypoxia in cancer therapy. Methods Enzymol, 2007, 435: 297-321.
4. Overgaard J. Hypoxic radiosensitization: adored and ignored. J Clin Oncol, 2007, 25: 4066-4074.
5. 侯如蓉, 翟光胜, 李文辉, 等. 放射增敏剂的研究进展. 中国辐射卫生, 2007, 16(4): 507-508.
6. 吴珊, 孙国平, 权循凤, 等. 食管癌根治性放射治疗联合放射增敏剂研究文献分析. 安徽医学, 2011, 32(7): 882-885.
7. 彭俊英, 吴金通, 沈芬, 等. 甘氨双唑钠(CMNa)对食管癌放射治疗增敏作用的临床观察. 海峡药学, 2011, 23(5): 164-165.
8. 孙菁, 王凤英, 高红军, 等. 甘氨双唑钠(CMNa)对食管癌放射治疗增敏作用的研究. 现代肿瘤医学, 2004, 12(5): 397-399.
9. 孙桂丽, 任志红, 韩忠发.甘氨双唑钠(CMNa)对食管癌放射治疗增敏作用的临床观察. 内蒙古民族大学学报(自然科学版), 2007, 22(6): 665-666.
10. 李喜茹, 冯建军, 韩宪春, 等. 甘氨双唑钠对Ⅲ和Ⅳ期食管癌患者放射增敏作用及不良反应观察. 中国药物与临床, 2010, 10(11): 1280-1281.
11. 蔡述华, 王捷忠, 林建辉, 等. 甘氨双唑钠对老年食管癌放射治疗增敏作用的临床分析. 福建医药杂志, 2009, 31(2): 128-129.
12. 陆雁. 甘氨双唑钠对食道癌放射治疗增敏作用的疗效观察及护理. 现代护理, 2008, 14(4): 516-517.
13. 蔡白振, 孔飞, 陈显钊. 甘氨双唑钠对食道癌放射治疗增敏作用的研究. 中国热带医学, 2008, 8(3): 416-417.
14. 侯良宝, 刘彦中, 李红霞, 等. 甘氨双唑钠对食管癌的放射增敏作用. 实用肿瘤学杂志, 2007, 21(5): 451-452.
15. 王明智, 吴伟, 吴刚, 等. 甘氨双唑钠对食管癌放疗增敏作用的临床观察. 中国现代医药杂志, 2011, 13(10): 63-65.
16. 钟小鹏, 白力, 邹文蕙, 等. 甘氨双唑钠对食管癌放射增敏作用的临床应用. 医药论坛杂志, 2008, 29(2): 58-61.
17. 赵永生, 辛芳, 赵娜, 等. 甘氨双唑钠对食管癌放射治疗增敏作用的临床研究. 中华现代临床医学杂志, 2007, 5(7): 607-608.
18. 李瑞锋, 胡燕华, 李艾恩, 等. 甘氨双唑钠对食管癌放射治疗增敏作用的研究. 福建医药杂志, 2005, 27(1): 76-77.
19. 程惠华, 傅志超, 林贵山, 等. 甘氨双唑钠对食管癌根治性放疗后复发再程放疗的增敏作用, 第四军医大学学报, 2007, 28(1): 39-41.
20. 朱蓉, 唐世芳, 李彩云, 等. 甘氨双唑钠对中晚期食管癌放射增敏作用的疗效观察与护理. 安徽医学, 2010, 31(8): 995-996.
21. 金红梅. 三维适形放射治疗食管癌联合希美钠增敏70例临床观察. 齐齐哈尔医学院学报, 2010, 31(14): 2232.
22. 叶永来, 田智峰, 王素青. 食管癌后程加速超分割放疗加甘氨双唑钠增敏的临床研究. 现代中西医结合杂志, 2006, 15(10): 1285-1286.
23. 高飞, 赵莺, 尹小祥, 等. 食管癌后程加速超分割放疗加甘氨双唑钠增敏的临床研究. 临床肿瘤学杂志, 2007, 12(7): 514-516.
24. 陆嘉德, Lee K, Hai M. 局部中晚期食管癌的多学科整合治疗. 中国癌症杂志, 2008, 18(5): 333-338.
25. van den Bogaert W, van der Schueren E, Horiot JC, et al. The EORTC randomized trial on three fractions per day and misonidazole (trial no 22811) in advanced head and neck cancer: long-term results and side effects. Radiotherapy and Oncol, 1995, 35(2): 91-99.
26. Lee DJ, Trotti A, Spencer S, et al. Concurrent tirapazamine and radiotherapy for advanced head and neck carcinomas: a phaseⅡstud. Int J Radiat Oncol Biol Phys, 1998, 42(4): 811-815.
27. 李迎春, 李宏斌, 陈成宏, 等. 甘氨双唑钠配合放疗治疗食管癌术后复发的近期疗效观察. 现代医药卫生, 2009, 25(11): 1608-1609.

Chinese Journal of Evidence-Based Medicine

Effectiveness and Safety of Radiosensitizer Metronidazole Amino Acidum Natrium for Esophagus Carcinoma: A Meta-Analysis

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