吉西他滨联合铂类与吉西他滨单药治疗晚期胰腺癌疗效的系统比较  

Comparision of efficacy between gemcitabine-platinum combination therapy and gemcitabine monotherapy in the management of advanced pancreatic cancer.

作　　者：李琴[1] 闫涵[1] 赵鹏飞[1] 张瑞雪[1] 原振龑 曹邦伟[1] 

机构地区：[1]首都医科大学附属北京友谊医院肿瘤科,北京100050

出　　处：《临床和实验医学杂志》2014年第16期1317-1321,共5页Journal of Clinical and Experimental Medicine

基　　金：国家自然科学基金资助项目(项目编号:81301912;李琴);国家自然科学基金资助项目(项目编号:81272615;曹邦伟);北京市卫生系统高层次卫生技术人才项目(项目编号:2011-3-007;曹邦伟);首都医科大学基础-临床合作课题资助项目(项目编号12JL33;2012-2013;李琴)

摘　　要：目的系统比较吉西他滨联合铂类与吉西他滨单药治疗晚期胰腺癌的临床疗效。方法检索PubMed、Embase、Cochrane Library、CNKI和万方数据库查找相关文献。主要观察终点为总生存时间(OS),次要观察终点为无疾病进展生存期(PFS),客观缓解率(ORR)。结果 10篇临床试验纳入Meta分析。共纳入2 711例患者,其中吉西他滨联合铂类组1 401例,吉西他滨单一治疗组1 310例。吉西他滨联合治疗组较吉西他滨单一治疗组没有显著提高晚期胰腺癌患者的OS[HR=1.00,95%CI(0.98-1.01),P=0.610]与PFS[HR=1.00,95%CI(0.98-1.01),P=0.704]。但吉西他滨联合治疗组显著改善晚期胰腺癌患者的ORR[RR=1.52,95%CI(1.27-1.82),P<0.001]。结论吉西他滨联合铂类药物显著改善晚期胰腺癌患者ORR,但并没有显著改善OS与PFS。Objective This study compared the efficacy of gemcitabine（ GEM）with GEM combined with platinum in the management of locally advanced/ metastatic pancreatic cancer（ LA/ MPC）. Methods A systematic search of trials,up to January 2014 was conducted by using PubMed,EMBASE,Cochrane Library,CNKI and wanfang database. The primary endpoint was overall survival（ OS）and secondary endpoints were progression free survival（ PFS）,objective response rate（ ORR）. Results 10 trials involving 2711 patients were included in this study. The results reported that there were no significant improvement of OS[HR =1. 00,95% C（I 0. 98 -1. 01）,P =0. 610]and PFS[HR = 1. 00,95% C（I 0. 98 -1. 01）,P =0. 704]in GEM combination therapy group compared to GEM monotherapy group. ORR was significantly increased[RR =1. 52,95% C（I 1. 27 -1. 82）,P ﹤0. 001]in GEM combination therapy group compared with GEM monotherapy group. Conclusion GEM combined with Platinum did not bring significant improvement of OS and PFS except ORR in LA/ MPC patients.

关 键 词：胰腺癌 吉西他滨 顺铂 奥沙利铂 Meta分析 

分 类 号：R735.9[医药卫生—肿瘤]