血管内皮生长因子抑制剂治疗晚期胃癌的Meta分析  

The role of anti-VEGF agents in the treatment of advanced gastric cancer:a meta-analysis

作　　者：冯姝婷[1] 由继辉[2] 李艳[1] 

机构地区：[1]辽宁省人民医院消化内一科,辽宁沈阳110016 [2]辽宁省人民医院呼吸内科,辽宁沈阳110016

出　　处：《临床和实验医学杂志》2016年第20期2004-2007,共4页Journal of Clinical and Experimental Medicine

摘　　要：目的探讨血管内皮生长因子（VEGF）抑制剂治疗晚期胃癌的临床疗效与安全性。方法检索Pub Med、Cochrane协作网、EMBASE、MEDLINE和CNKI等中英文数据库,时间年限为建库至2015年6月,检索VEGF抑制剂治疗晚期胃癌的随机对照试验（RCT）,并用Revman 5.0软件对其进行分析,以总生存期、无病生存期、总缓解率和3级以上不良反应为结局指标。结果共纳入7个ROC共2 281例晚期胃癌患者。与非VEGF抑制剂的对照组比较,VEGF抑制剂治疗的患者可获得更长的总生存期（HR=0.754,95%CI：0.2-2.9,P〈0.001）,更长的无病生存期（HR=0.625,95%CI：0.385~0.812,P〈0.001）。与无VEGF抑制剂治疗比较,VEGF抑制剂治疗可能发生更多3级以上不良反应。结论 VEGF抑制剂可显著延长晚期胃癌患者的总体生存期,但还需要更多质量高的随机对照试验进行验证。Objective To study the effectiveness and security of anti-VEGF agents in the treatment of advanced gastric cancer.Methods We performed a meta-analysis of randomized controlled trials（ RCTs） to assess the efficacy and safety of anti-VEGF agents in the treatment of AGC.Several databases were searched,including Pub Med,EMBASE,Cochrane Central Register of Controlled Trials,MEDLINE and CNKI.The endpoints were overall survival（ OS）,progression-free survival（ PFS）,overall response rate（ ORR）,and grade 3 or 4 adverse events（ AEs）.Results Seven RCTs which involved 2,340 patients were ultimately identified.The pooled analysis demonstrated that anti-VEGF therapy significantly improved OS（ HR = 0.754,95% CI：0.532 - 0.859,P 〈0.001）,PFS（ HR = 0.625,95% CI：0.385 -0.812,P 〈0.001）,and ORR（ RR = 1.276,95% CI：1.103-1.530,P 〈0.001） when compared to non-anti-VEGF therapy.Sensitivity analysis further confirmed this association.Additionally,more incidences of grade 3 or 4 thrombocytopenia,diarrhea,and hypertension were observed in anti-VEGF therapy.Conclusion The anti-VEGF therapy offers a significant survival benefit in patients with AGC,especially for those previously treated patients,when compared to non-anti-VEGF therapy.With the present available data from randomized clinical trials,we could not clearly set the role of specific anti-VEGF agents in the treatment of AGC.Further high quality studies are recommended to identify patients who could derive greater benefits from specific anti-VEGF agents.

关 键 词：晚期胃癌 VEGF抑制剂 META分析 

分 类 号：R735.2[医药卫生—肿瘤]