吉西他滨单药与以其为基础的联合化疗治疗进展期胰腺癌疗效的meta分析  

Meta-analysis of the efficacy between gemcitabine-alone and gemcitabine-based chemotherapy applied in advanced pancreatic cancer

作　　者：宋堃[1] 李滨[1] 孙维佳[1] 

机构地区：[1]中南大学湘雅医院普外科,长沙410008

出　　处：《中华外科杂志》2011年第9期839-842,共4页Chinese Journal of Surgery

摘　　要：目的研究吉西他滨（GEM）单药与以吉西他滨为基础的两种药物联合用药（GEMCOM）对于进展期胰腺癌的治疗效果。方法以Phasem、gemcitabine、pancreaticcancer为检索词，在Pubmed中检索2002至2010年GEM和GEMCOM治疗进展期胰腺癌三期临床试验文献，以文献为基础采用固定效应模型或随机效应模型对客观缓解率、1年生存率进行meta分析。结果Meta分析的结果显示，14个临床随机对照试验（RCT）入选客观缓解率分析，结果为GEMCOM组客观缓解率优于GEM单用组（z=4．400，P=0．000）；10个RCT人选两组1年生存率分析，GEMCOM组1年生存率高于GEM单用组（z=2．190，P=0．028）。14个RCT获益率分析发现，GEMCOM组获益率高于GEM单用组（z=4．400，P=0．000）。通过Egger直线回归法检测，入选客观缓解率分析的14个RCT中，尚不能说明存在发表偏倚（t=0．070，P=0．946）；入选1年生存率分析的10个RCT中，尚不能说明存在发表偏倚（t=-0．740，P=0，483）。结论吉西他滨联合用药的客观缓解率、1年生存率、获益率高于吉西他滨单独用药组。吉西他滨联合用药有优于吉西他滨单用的可能。Objective To compare the efficacy of gemcitabine （GEM）alone and gemcitabine based combination chemotherapy （ GEMCOM ） on advanced pancreatic cancer. Methods Keywords Phase III, gemcitabine and pancreatic cancer were used to search and collect Phase i-randomized references about gemcitabine and gemcitabine-based combination chemotherapy applied on advanced pancreatic cancer. A references-based recta-analysis was made to compare the efficacy between GEM and GEMCOM. Before that, test for heterogeneity was committed. Fixed effect model was used if the I2 〈~50% ,and random effect model was used if not. The evaluating indicators were overall response rate and 1-year survival rate. Results There were 14 randomized controlled trial（RCT） and 10 RCT enrolled in overall response rate analysis and 1-year survival rate analysis, respectively. Results of meta-analysis showed that, arm GEMCOM＇ s overall response rate and 1-year survival rate were higher than arm CEM＇s（z =2. 190,P =0. 028 vs. z =4. 400,P =0. 000）. The differences were significant. The biases of the results were tested by Egger-test. The tests showed that no bias exists in both of two recta-analysis （ t = 0. 070, P = 0. 946 and t = - 0. 740, P = 0. 483 ） respectively. Conclusion There is a possibility that the gemcitabine-eombination is more effective than the gemcitabine on overall response rate and 1-year survival rate.

关 键 词：META分析 胰腺肿瘤 吉西他滨 化疗 三期临床试验 

分 类 号：R735.9[医药卫生—肿瘤]