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替吉奥或卡培他滨联合奥沙利铂治疗晚期结直肠癌的疗效与安全性的Meta分析
陈君茹,吴迅,李光明,张欣平,杨健筌,吴敬波
0
(西南医科大学附属医院肿瘤科;南充市中心医院肿瘤防治中心)
摘要:
【摘要】 目的 系统评价替吉奥联合奥沙利铂与卡培他滨联合奥沙利铂治疗晚期结直肠癌的疗效和安全性。方法 计算机检索PubMed、Embase、Medline、Cochrane Library、中国期刊全文数据库(CNKI)、维普中文科技期刊全文数据库(VIP)、中国生物医学文献数据库(CBM)、万方数据库,按照纳入、排除标准进行文献筛选并提取数据,使用改良版Jadad量表评价方法学质量。定义替吉奥联合奥沙利铂化疗者为替吉奥组,卡培他滨联合奥沙利铂化疗者为卡培他滨组。采用RevMan 53版软件对两组客观缓解率、疾病控制率、中位生存期、中位总生存期(mOS)、中位无进展生存期(mPFS)和不良反应进行Meta分析。结果 纳入11个随机对照试验(RCT),共1439例患者。分析结果显示,两组在客观缓解率(OR=125,95% CI:098~160,P=007)、疾病控制率(OR=121,95% CI:091~162,P=02)差异均无统计学意义(P>005);替吉奥组在mPFS方面表现出优势(HR=081,95% CI:068~097,P=002),两组在mOS(OR=084,95% CI:070~101,P=006)方面的差异无统计学意义。安全性方面,替吉奥组1~4级的厌食(P=001)和1~4级的口腔炎(P=002)发生率高于卡培他滨组,替吉奥组3~4级的肝功能受损(P=001)发生率低于卡培他滨组,替吉奥组任何级别的手足综合征发生率均明显低于卡培他滨组(1~4级毒性反应:P<000001;3~4级毒性反应:P=001);其他不良反应差异无统计学意义(P>005)。结论 替吉奥联合奥沙利铂和卡培他滨联合奥沙利铂治疗晚期结直肠癌患者的近期疗效相当。但替吉奥联合奥沙利铂的毒性反应更小,安全性更好。
关键词:  替吉奥  卡培他滨  奥沙利铂  晚期结直肠癌  Meta分析
DOI:
基金项目:四川省科技厅科技计划项目(2012JY0044);四川省卫生厅科研课题(120282)
A Meta analysis of the efficacy and safety of S 1 plus oxaliplatin versus capecitabine plus oxaliplatin for first line treatment of patients with advanced colorectal cancer
CHEN Junru,WU Xun,LI Guangming,ZHANG Xinping,YANG Jianquan,WU Jingbo
(Department of Oncology, Southwest Medical University;Oncology Center, Nanchong Central Hospital)
Abstract:
【Abstract】 Objective To investigate the efficacy and safety of S1 plus oxaliplatin versus capecitabine plus oxaliplatin for firstline treatment of patients with advanced colorectal cancer.Methods Computerbased retrieval was performed on Pubmed, Embase,Medline,Cochrane Library,CBM,VIP,CNKI and Wanfang Database.Papers were selected according to the inclusion and exclusion criteria. After collecting the data and evaluating the methodological quality of the included studies, RevMan 53 software was used to perform Metaanalysis.Results 11 RCTs involving 1439 patients were included.Metaanalysis indicated that the objective response rate (OR=125, 95% CI:098~160,P=007) and disease control rate (OR=121, 95% CI:091~162,P=02), showed no statistical significance between S1 combined with oxaliplatin and oxaliplatin combined with capecitabine. For adverse reactions,S1 combined with oxaliplatin could increased incidence of grade 14 anorexia (P=001), oral mucositis (P=002),but decrease the incidence of grade 34 liver function damage (P=001) and the incidence of hand foot syndrome (grade 14: P<000001; grade 34: P=001). There were no statistical difference between the two regimen in other adverse reactions.Conclusion Compared with capecitabine combined with oxaliplatin, S1 combined with oxaliplatin seem to have similar shortterm efficacy in the firstline treatment for advanced colorectal cancer.However, S1 combined with oxaliplatin has a lower incidence of toxicities.
Key words:  S 1  Capecitabine  Oxaliplatin  Advanced colorectal cancer  Meta analysis

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