进展期胃癌术中区域性缓释化疗的安全性评价—Meta分析  

Intraoperative implant of regional sustained-release 5-FU chemotherapy for advanced gastric cancer: a Meta-analysis

作　　者：袁殿宝[1] 文西年[1] 王云海[1] 许新才[1] 李涛[1] 

机构地区：[1]新疆医科大学第一附属医院胃肠外科,新疆乌鲁木齐830054

出　　处：《实用肿瘤杂志》2013年第4期400-404,共5页Journal of Practical Oncology

摘　　要：目的评价氟尿嘧啶(5-FU)缓释剂在治疗进展期胃癌中的疗效,为临床用药提供循证依据。方法利用Meta分析综合评价国内公开发表的所有关于进展期胃癌术中区域性缓释化疗的文献。最终符合选入标准的文献11篇,共1 079例患者。根据术中是否植入5-FU缓释剂分为治疗组578例,对照组501例。采用RevMan 5.1软件进行统计学分析,评价指标:术后并发症,1、3、5年生存率及3年无瘤生存率。结果 Meta分析结果显示,两组术后1年生存率差异无统计学意义(RR=1.04,95%CI:0.97～1.12,P=0.30);治疗组3年生存率(RR=1.37,95%CI:1.19～1.57)、5年生存率(RR=2.92,95%CI:1.93～4.41)及3年无瘤生存率(RR=2.39,95%CI:1.43～4.00)均高于对照组(均P<0.05)。两组在不良反应及并发症发生率方面差异无统计学意义(P>0.05)。结论进展期胃癌术中应用5-FU缓释剂能够取得较好的远期预后效果,且不会增加不良反应及并发症的发生率。Objective To evaluate the efficacy and safety of intraoperative implant of regional sustained-release 5-fluorouracil （5-FU） for advanced gastric cancer. Methods The literatures on intraoperative implant of regional sustained-release 5-FU chemotherapy for advanced gastric cancer were searched for meta-analysis. Eleven literatures and I 079 patients were included, including 578 patients in treatment group and 501 patients in control group. The end-point for evaluation included postoperative complications, 1, 3 and 5-y survival rates and 3-y disease free survival rate. Meta-analysis was performed with RevMan 5.1 software. Results Fluorouracil implants improved 3 and 5-y survival rates and also 3-y disease free survival rate（RR = 1.37, 95% CI. 19 1.57 ; RR = 2.92, 95 % CI： 1.93 - 4.41, respectively ; RR = 2. 39, 95 % CI： 1.43 N 4.00 ; all P 〈 0.05 ）. There were no significant differences in 1-y survival rate（RR = 1.04,95% CI：0. 97 1.12, P = 0.30）and adverse effects between treatment and control groups （ P 〉 0.05 ）. Conclusion 5-FU implants may modestly improve the outcome of advanced gastric cancer patients without increasing its adverse events.

关 键 词：胃肿瘤 药物疗法 氟尿嘧啶 治疗应用 迟效制剂 胃肿瘤 外科学 存活率 可吸收性植入物 安全 META分析 

分 类 号：R735.2[医药卫生—肿瘤] R730.53[医药卫生—临床医学]