国际肿瘤学杂志
國際腫瘤學雜誌
국제종류학잡지
JOURNAL OF INTERNATIONAL ONCOLOGY
2014年
3期
233-237
,共5页
胰腺肿瘤%药物疗法%Meta分析%吉西他滨
胰腺腫瘤%藥物療法%Meta分析%吉西他濱
이선종류%약물요법%Meta분석%길서타빈
Pancreatic neoplasms%Drug therapy%Meta-analysis%Gemcitabine
目的 通过Meta分析,探讨吉西他滨(GEM)联合替吉奥(S-1)和GEM单药化疗在晚期胰腺癌治疗中的意义.方法 计算机检索Pubmed、Cochrane Library、EMBASE、中国知网数据库、中国生物医学文献数据库,查找从数据库建库至2013年8月1日国内外已发表的相关文献.选择治疗组为GEM联合S-1化疗,对照组为GEM单药化疗治疗晚期胰腺癌的随机对照试验.由两位评价者分别检索、收集资料,按纳入标准入选,主要分析指标为生存优势(包括生存率和疾病无进展生存率),次要分析指标为客观缓解率、疾病控制率和不良反应.结果 共纳入3个随机对照试验.Meta分析显示GEM+ S-1联合化疗能明显延长患者的疾病无进展生存期(HR=0.64,95％ CI为0.54～0.75,P＜0.00001)及总生存期(HR=0.81,95％ CI为0.68～0.96,P=0.01),提高客观缓解率[风险差异(risk difference,RD)=0.16,95％ CI为0.10 ～0.21,P＜0.000 01]及疾病控制率(RD =0.10,95％CI 0.03 ～0.17,P=0.009),但同时3、4级不良反应也明显升高,中性粒细胞减少增加18％(P=0.02)、血小板减少增加6％ (P=0.008)、胃肠道反应增加8％(P＜ 0.000 01).结论 GEM联合S-1用于晚期胰腺癌患者疗效确有明显提高,虽不良反应也明显增加,但总体生存获益有所提高.
目的 通過Meta分析,探討吉西他濱(GEM)聯閤替吉奧(S-1)和GEM單藥化療在晚期胰腺癌治療中的意義.方法 計算機檢索Pubmed、Cochrane Library、EMBASE、中國知網數據庫、中國生物醫學文獻數據庫,查找從數據庫建庫至2013年8月1日國內外已髮錶的相關文獻.選擇治療組為GEM聯閤S-1化療,對照組為GEM單藥化療治療晚期胰腺癌的隨機對照試驗.由兩位評價者分彆檢索、收集資料,按納入標準入選,主要分析指標為生存優勢(包括生存率和疾病無進展生存率),次要分析指標為客觀緩解率、疾病控製率和不良反應.結果 共納入3箇隨機對照試驗.Meta分析顯示GEM+ S-1聯閤化療能明顯延長患者的疾病無進展生存期(HR=0.64,95％ CI為0.54～0.75,P＜0.00001)及總生存期(HR=0.81,95％ CI為0.68～0.96,P=0.01),提高客觀緩解率[風險差異(risk difference,RD)=0.16,95％ CI為0.10 ～0.21,P＜0.000 01]及疾病控製率(RD =0.10,95％CI 0.03 ～0.17,P=0.009),但同時3、4級不良反應也明顯升高,中性粒細胞減少增加18％(P=0.02)、血小闆減少增加6％ (P=0.008)、胃腸道反應增加8％(P＜ 0.000 01).結論 GEM聯閤S-1用于晚期胰腺癌患者療效確有明顯提高,雖不良反應也明顯增加,但總體生存穫益有所提高.
목적 통과Meta분석,탐토길서타빈(GEM)연합체길오(S-1)화GEM단약화료재만기이선암치료중적의의.방법 계산궤검색Pubmed、Cochrane Library、EMBASE、중국지망수거고、중국생물의학문헌수거고,사조종수거고건고지2013년8월1일국내외이발표적상관문헌.선택치료조위GEM연합S-1화료,대조조위GEM단약화료치료만기이선암적수궤대조시험.유량위평개자분별검색、수집자료,안납입표준입선,주요분석지표위생존우세(포괄생존솔화질병무진전생존솔),차요분석지표위객관완해솔、질병공제솔화불량반응.결과 공납입3개수궤대조시험.Meta분석현시GEM+ S-1연합화료능명현연장환자적질병무진전생존기(HR=0.64,95％ CI위0.54～0.75,P＜0.00001)급총생존기(HR=0.81,95％ CI위0.68～0.96,P=0.01),제고객관완해솔[풍험차이(risk difference,RD)=0.16,95％ CI위0.10 ～0.21,P＜0.000 01]급질병공제솔(RD =0.10,95％CI 0.03 ～0.17,P=0.009),단동시3、4급불량반응야명현승고,중성립세포감소증가18％(P=0.02)、혈소판감소증가6％ (P=0.008)、위장도반응증가8％(P＜ 0.000 01).결론 GEM연합S-1용우만기이선암환자료효학유명현제고,수불량반응야명현증가,단총체생존획익유소제고.
Objective To compare the gemcitabine (GEM) plus S-1 and gemcitabine alone in the treatment of advanced pancreatic cancer (PC) by meta-analysis.Methods Articles were searched in PubMed,Cochrane library,Embase,CNKI,and CBM up to August 1st,2013.Only randomized controlled trails (RCTs) for GEM + S-1 and GEM alone in advanced PC were included.Two reviewers retrieved and collected data respectively.Data were selected basing on inclusion and exclusion criteria.The meta-analysis was base on survival advantage (include overall survival and progress free survival),object response rate,disease control rate and adverse reaction.Results A total of 3 trials with 772 cases were included.Meta-analysis demonstrated that GEM plus S-1 significantly improved the progress free survival (HR:0.64,95％CI:0.54-0.75,P ＜ 0.000 01) and overall survival (HR:0.81,95％CI:0.68-0.96,P =0.01),improved object response rate (RD:0.16,95％ CI:0.10-0.21,P ＜ 0.000 01) and disease control rate (RD:0.10,95％ CI:0.03-0.17,P =0.009) also.However,the incidence of WHO 3/4 grade adverse reaction was increased significantly in the GEM + S-1 group.Neutropenia,thrombocytopenia,and gastrointestinal reaction were increased by 18％ (P =0.02),18％ (P =0.008) and 8％ (P ＜ 0.000 01)respectively.Conclusion GEM combined with S-1 can improve the chemotherapy effect compared with GEM alone.The adverse reactions also increase significantly,but the overall survival is benefit.
