吉西他滨联合化疗一线治疗晚期胰腺癌生存结果的亚组meta分析  

Subgroup Meta-analyses of Survival Rate of Gemcitabine-based Combination Chemotherapy as First-line Therapy for Advanced Pancreatic Cancer

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

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

出　　处：《中山大学学报（医学科学版）》2007年第5期565-569,共5页Journal of Sun Yat-Sen University:Medical Sciences

摘　　要：【目的】Meta分析提示吉西他滨(GEM)联合化疗一线治疗晚期胰腺癌优于标准的GEM单药化疗,在此基础上进行亚组生存结果的meta分析及资料更新,旨在寻找确切有效的化疗方案。【方法】通过MEDLINE、EMBASE、ASCO、ECCO等数据库及论文集检索相关文献。按纳入标准筛选新增文献并进行资料更新。主要对各亚组进行半年生存率、其次是1年生存率的meta分析。【结果】17个随机对照临床试验(RCT)共3 821例患者纳入分析,按化疗方案分为GEM联合顺铂(GEMDDP)、GEM固定剂量率输注联合奥沙利铂(GEMOX)、联合5FU(GEMFU)、联合卡培他滨(GEMCAP)以及联合伊立替康(GEMIRI)等5个亚组,各亚组半年生存率的治疗优势(RD)分别为5%(P=0.24)、9%(P=0.005)、2%(P=0.46)、7%(P=0.03)和-1%(P=0.88);1年生存率RD为6%(P=0.11)、5%(P=0.07)、4%(P=0.19)、5%(P=0.08)和0(P=0.97)。【结论】现有的证据提示GEMOX、GEMCAP联合化疗方案一线治疗晚期胰腺癌,有较好的应用前景,值得进一步的临床试验。[Objective] Previous meta-analyses had shown gemcitabie （GEM）-based combination chemotherapy was superior to GEM monotherapy for advanced pancreatic cancer （APCa）, Subgroup analyses were performed using updated information to seek for the exactly effective GEM-based combination regimen to benefit patients with APCa. [Methods] Subgroup meta-analyses of all previously published or unpublished studies were performed with a comprehensive search of the updated literature including MEDLINE, EMBASE, ASCO and ECCO. The analyses included all randomized evidence to compare GEM combination chemotherapy with GEM alone with respect to 6- month survival rate （6-mo SR） and 1-year survival rate （1-y SR） in APCa patients. [Results] Seventeen RCTs involving 3821 patients were included in this meta-analysis, which were divided into five subgroups according to the combination chemotherapy regimen, GEM plus cisplatin （GEMDDP）, fixed-dose rate infusion of GEM plus oxaliplatin （GEMOX）, GEM plus 5-fluorouracil （GEMFU）, GEM plus capecitabine （GEMCAP） and GEM plus irinotecan （GEMIRI）. Subgroup analyses showed the risk difference （RD） of 6-mo SR were 5% （P=0.24）, 9% （P= 0.005）, 2% （P=0.46）, 7% （P=0.03） and -1% （P=0.88）, respectively; and the 1-y SR 6% （P=0.11）, 5% （P=0.07）, 4% （P=0.19）, 5% （P=0.08）, and 0% （P=0.97）, respectively. [Conclusion] Based on the available evidence, GEMOX and GEMCAP regimens may be considered promising regimen as the front-line therapy for APCa, which encourages further clinical trials.

关 键 词：胰腺肿瘤 化学疗法 吉西他滨 卡培他滨 奥沙利铂 META分析 

分 类 号：R735.1[医药卫生—肿瘤]