5-FU与IFNα联合治疗晚期大肠癌的肿瘤反应率和毒性11个随机对照临床试验的Meta分析  

Tumor response rate and toxicity of fluorouracil with or without interferon alpha in patients with advanced colorectal cancer:a meta-analysis of 11 randomized trials.

作　　者：邹鸿志[1] 郁宝铭[1] 赵任[1] 王志伟[2] 

机构地区：[1]上海第二医科大学瑞金医院普外科,200025 [2]上海第二医科大学细胞生物学实验室

出　　处：《中国实用外科杂志》2001年第7期409-412,共4页Chinese Journal of Practical Surgery

摘　　要：目的　评价IFNα对 5 FU(FA)治疗晚期大肠癌的肿瘤反应率和毒性的影响。方法　共检索出符合入选标准的随机对照临床试验 11项 ,采用固定效应模型和随机效应模型对 182 6例病人的肿瘤反应率和毒性资料进行Meta分析。结果　 5 FU(FA) +IFNα治疗晚期大肠癌总的肿瘤反应率与单用 5 FU(FA)化疗者相比差别无显著性 (2 1 7%比 2 3 3 % ,OR =0 92 ,95 %CI,0 6 6～ 1 2 8,P =0 6 1) ;按亚型分组分析发现 ,5 FU (FA) +IFNα 2b组的肿瘤反应率较 5 FU(FA)化疗者低 (2 0 9%比 2 9 7% ,OR =0 6 6 ,95 %CI,0 48～ 0 91,P =0 0 1) ;另外 ,IFNα 2a和 2c均对晚期大肠癌的肿瘤反应率无显著影响。毒性分析表明 ,IFNα增加 5 FU(FA)引起 3、4级血液毒性 (P =5 5× 10 -4 )和发热 (P =0 0 0 6 )的机会。结论　IFNα不仅不能提高 5 FU(FA)治疗晚期大肠癌的疗效 ,而且增加毒性 ,不宜临床推广使用。Objective To evaluate tumor response rate and toxicity of fluorouracil(5-FU)with or without interferon alpha(IFNα)in patients with advanced colorectal cancer.Methods Data of 1826 patients included in 11 randomized trials were meta-analyzed using fixed effect model or random effect model.Results Tumor response rate was identical between patients assigned to 5-FU and IFNα and those assigned to 5-FU only(21.7% vs 23.3%,OR=0.92,95% CI,0.66～1.28,P=0.61).When tumor response rate was analyzed according to subtype of IFNα,it was significantly lower in patients assigned to 5-FU and IFNα-2b than those assigned to 5-FU only(20.9% vs 29.7%,OR=0.66,95% CI,0.48-0.91,P=0.01),but IFNα-2a,-2c had no influence upon tumor response rate.Grade 3 or 4 hematologic toxicity(P=5.5×10 -4 )and fever(P=0.006)were more frequent in patients assigned to 5-FU and IFNα.Conclusion IFNα does not improve efficacy of 5-FU in advanced colorectal cancer,but significantly worsen toxicity,so it can not be recommended for routine use.

关 键 词：5-氟尿嘧啶 干扰素 META分析 大肠癌 IFNΑ 肿瘤反应率 毒性 

分 类 号：R735.34[医药卫生—肿瘤] R730.53[医药卫生—临床医学]