吉西他滨联合卡培他滨一线治疗晚期胰腺癌的Meta分析  

Gemcitabine plus capecitabine as a front-line therapy for advanced pancreatic cancer:a meta-analysis

作　　者：谢德荣[1] 梁汉霖[2] 杨琼[1] 郭双双[1] 江志敏[1] 陈邓林[1] 

机构地区：[1]中山大学附属第二医院肿瘤科,广东省广州市510120 [2]中山大学附属中山市人民医院化疗科,广东省中山市528403

出　　处：《世界华人消化杂志》2007年第16期1868-1871,共4页World Chinese Journal of Digestology

摘　　要：目的:通过Meta分析,探讨吉西他滨(GEM)与卡培他滨(CAP)联合化疗方案(GEMCAP)一线治疗晚期胰腺癌的地位和价值.方法:通过MEDLINE、EMBASE、ASCO、ECCO等数据库及论文集检索国内外已发表和未发表的相关文献.选择治疗组为GEMCAP方案化疗,对照组为GEM单药化疗的晚期胰腺癌随机对照试验(randomized controlled trial,RCT).由2位评价者分别按上述检索策略收集资料,按纳入标准筛选文献,主要对总生存率、其次是客观缓解率和毒副反应进行Meta分析.结果:从316篇文献中筛选出符合纳入标准的3个RCT,涉及932例患者.GEMCAP联合化疗与GEM单药化疗相比,联合化疗组半年生存率提高7%(RD=0.07,95%CI 0.01-0.13,P= 0.03),客观缓解率提高6%(RD=0.06,95% CI 0.02-0.10,P=0.004);3/4度毒手足综合征增加2%(RD=0.02,95%CI 0.00-0.04,P=0.02),其他毒副反应两组差别无统计学意义.结论:GEMCAP方案治疗晚期胰腺癌,可以改善患者的半年生存率,没有明显增加毒副反应.现有的证据支持GEMCAP方案用于晚期胰腺癌的一线治疗,值得进一步的临床试验.AIM： To use a meta-analysis to explore the therapeutic effects of gemcitabine （GEM） plus capecitabine （CAP） as a front-line therapy in patients with advanced pancreatic cancer （APCa）. METHODS： A meta-analysis of all previously published and some unpublished studies were performed with a comprehensive search of the literatures included in MEDLINE, EMBASE, ASCO and ECCO. The meta-analysis included all randomized evidence to compare GEM plus CAP （GEMCAP） with GEM alone with respect to overall survival rate, objective remission rate and toxicities in APCa patients. RESULTS： Of 316 reports, three randomized controlled trials involving 932 APCa patients were identified by two reviewers. The GEMCAP combination group showed a significant improvement in 6-month survival rate （RD = 0.07, 95%CI 0.01-0.13, P = 0.03） and objective remission rate （RD = 0.06, 95%CI 0.02-0.10, P = 0.004）. The incidence of WHO 3/4 grade hand-foot syndrome was higher in the GEMCAP combination group （RD = 0.02, 95%CI 0.00-0.04, P = 0.02）. No significant differences were observed for other toxicities between the two arms. CONCLUSION： GEMCAP combination chemotherapy may improve the six-month survival rate without significantly increasing toxicities besides that of hand-foot syndrome. Based on the available evidence, GEMCAP may be considered a standard front-line therapy for patients with APCa. Our results raise a critical issue that needs evaluating in future clinical trails.

关 键 词：胰腺肿瘤 化学疗法 吉西他滨 卡培他滨 META分析 

分 类 号：R735.9[医药卫生—肿瘤]