The Application Of Bayesian Metaanalysis On The Evalution Of Therapeutic Effect Of Monoclonalant-EGFR In The Treatment Of Nasopharyngeal Carcinoma

Objective Use Bayesian Meta-analysis to evaluate the efficacy and Safety of epidermal growth factor receptor monoclonal antibody combined radiotherapy and chemotherapy for nasopharyngeal carcinoma.Comparing different treatment methods of epidermal growth factor receptor monoclonal antibody based on Bayesian Networks Meta-analysis methods.Then, choosing the best interventions that may provide a reference for future clinical and scientific research.Method The Cochrane Library, Pub Med, EMbase, CBM, CNKI,VIP database were searched. Randomized controlled trials(RCTs) and quasi-randomized controlled trials(CCT) have been collected if it was related to concurrent radiotherapy and chemotherapy EGFR monoclonal antibody treatment of nasopharyngeal carcinoma. Studies were selected and the quality of included studies was assessed according to the principles of systematic reviews. Meta-analysis use Rev Man 5.3statistical software to compute.STATA14.0 statistics and Win BUGS1.4.3to complete the data merge. Network Meta-analysis using Microsoft Excel loaded Net Meta XL macro call Win BUGS1.4.3 for analysis.Result Traditional Meta analysis showed that the efficacy of EGFR monoclonal antibody therapy combined with radiotherapy and chemotherapy is superior to nasopharyngeal carcinoma radiotherapycombined with chemotherapy. For Nimotuzumab, complete remission rate OR, 95% CI = 3.232,(2.276,4.461), objective response OR, 95% CI= 3.678(2.256,5.685), for cetuximab completely efficient OR, 95% CI =3.023,(1.755,4.876), objective response OR, 95% CI = 3.304,(1.884,5.403); compared with radiotherapy combined with chemotherapy,nimotuzumab combined with the side effects of radiotherapy and chemotherapy for nasopharyngeal carcinoma not increased,?~?grade leukopenia incidence of OR, 95% CI = 1.267,(0.8531,1.817), ?~?grade incidence of nausea and vomiting OR, 95% CI = 1.07,(0.5968,1.778), ? ~ ? The incidence of grade thrombocytopenia OR,95% CI = 0.6665,(0.2419,1.489), ? ~ ? grade incidence of radiation-induced skin damage OR, 95% CI = 1.317,(0.8602,1.934),? ~ ? grade oral mucositis occurs rate OR, 95% CI = 1.434,(0.6461,2.78), ?~? grade hemoglobin decrease the incidence of OR,95% CI = 0.9242,(0.4564,1.681); 1-year survival rate of OR, 95% CI =1.902,(0.8061,3.844), 2-year survival rate of OR, 95% CI = 2.333,(0.9895,4.713). Network Meta-analysis showed that,compared with radiotherapy alone, the complete remission rate of concurrent radiotherapy and chemotherapy EGFR monoclonal antibodies,radiotherapy with EGFR monoclonal antibody were statistically significant. OR values and 95% CI were 2.66(1.37,5.31), 4.35(2.28,8.30);Compared with concurrent chemotherapy, the complete remission rate of concurrent radiotherapy and chemotherapy EGFR monoclonal antibodies,radiotherapy with EGFR monoclonal antibody were statistically significant.OR values and 95% CI were 2.67(1.73,4.37), 4.35(1.91,10.23); Concurrent chemotherapy combined with EGFR monoclonal antibody was no significant difference with the United EGFR monoclonal antibody. According to the value of SUCRA, the possibility ofEGFR monoclonal antibody radiotherapy as the optimal treatment regimen is the largest.In terms of objective response, concurrent radiotherapy and chemotherapy EGFR monoclonal antibodies,radiotherapy with EGFR monoclonal antibody were statistically significant compared with radiotherapy alone, OR and 95% CI values were 7.67(1.18,52.32), 8.74(1.04,73.49). The rest were no statistically significant. According to the SUCRA, the possibility of chemotherapy combined EGFR monoclonal antibody is the optimal treatment regimen is the largest.Conclusion The short-term efficacy and safety of chemotherapy combined EGFR monoclonal antibody therapy are good. With the limits of the number and quality of literature, we need further follow-up studies.Using cisplatin as chemotherapy, EGFR monoclonal antibody EGFR monoclonal antibody in combination with radiotherapy and chemoradiotherapy was no significant difference, Since the literature does not provide long-term efficacy and safety indicators, We need further study to observe the long-term efficacy and safety to determine the best treatment strategy.