吉西他滨单药或联合白蛋白结合型紫杉醇治疗东亚人群晚期胰腺癌临床疗效的荟萃分析  

The meta-analysis of clinical efficacy of gemcitabine monotherapy and gemcitabine combined with nab-paclitaxel for East Asian patients with advanced stage pancreatic adenocarcinoma

作　　者：魏蕾[1] 李自雄 秦叔逵[1] 刘秀峰 WEI Lei;LI Zixiong;QIN Shuqui;LIU Xiufeng(Department of Medical Oncology,Cancer Center of PLA,81 Hospital Affiliated to Nanjing University of Chinese Medicine,Nanjing 210002,China)

机构地区：[1]南京中医药大学附属八一医院全军肿瘤中心肿瘤内科,南京210002

出　　处：《临床肿瘤学杂志》2019年第2期137-144,共8页Chinese Clinical Oncology

摘　　要：目的系统评价吉西他滨单药和吉西他滨联合白蛋白结合型紫杉醇一线治疗东亚人群晚期转移性胰腺癌的疗效,以期为中国转移性胰腺癌临床一线治疗的合理用药提供依据。方法按照预设的纳入和排除标准,在万方、Cochran Library、MEDLINE、PubMed和CNKI等数据库中系统性检索2010年1月至2018年6月发表的文献。主要观察终点为客观缓解率(ORR),次要终点为无进展生存期(PFS)和总生存期(OS)。提取纳入文献的相关资料,采用Rav Man 3. 5. 0版软件进行Meta分析。结果共纳入38项研究,合计1945例患者。吉西他滨单药治疗晚期胰腺癌的ORR为0. 15(95%CI:0. 11～0. 18)、中位PFS为3. 39(95%CI:2. 74～4. 05)个月、中位OS为7. 39(95%CI:6. 54～8. 23)个月;吉西他滨联合白蛋白结合型紫杉醇治疗晚期胰腺癌的ORR为0. 40(95%CI:0. 29～0. 52)、中位PFS为5. 68(95%CI:4. 30～7. 06)个月、中位OS为9. 80(95%CI:7. 89～11. 71)个月。结论吉西他滨联合白蛋白结合型紫杉醇与吉西他滨单药比较,具有明显的优效性,适合东亚人群,特别是中国晚期胰腺癌患者。Objective To systematically evaluate the efficacy of gemcitabine monotherapy and gemcitabine combined with nab-paclitaxel in the first-line treatment of advanced metastatic pancreatic cancer in East Asian population,in order to provide a reference for the clinical rational use of gemcitabine in the first-line treatment of patients with metastatic pancreatic cancer in China. Methods According to the preset inclusion and exclusion criteria,literatures published from January 2010 to June2018 were systematically searched in Wanfang,Cochran Library,MEDLINE,PubMed and CNKI databases. The primary endpoint was objective remission rate( ORR),and the secondary endpoint was progression-free survival( PFS) and overall survival( OS). Then the related data was extracted and meta-analysis was performed by using Rev Man 3. 5. 0 statistical software. Results A total of 38 studies involving 1945 patients were included. The ORR of gemcitabine monotherapy for advanced pancreatic cancer was 0. 15( 95% CI: 0. 11-0. 18),the median PFS was 3. 39( 95% CI: 2. 74-4. 05) months,and the median OS was7. 39( 95% CI: 6. 54-8. 23) months. The ORR of gemcitabine combined with nab-paclitaxel in the treatment of advanced pancreatic cancer was 0. 40( 95% CI: 0. 29-0. 52),the median PFS was 5. 68( 95% CI: 4. 30-7. 06) months,and the median OS was 9. 80( 95% CI: 7. 89-11. 71) months. Conclusion Compared with gemcitabine monotherapy,gemcitabine combined with albumin-bound paclitaxel has obvious superiority and is suitable for East Asian population,especially for patients with advanced pancreatic cancer in China.

关 键 词：晚期转移性胰腺癌 吉西他滨 白蛋白结合型紫杉醇 荟萃分析 

分 类 号：R735.9[医药卫生—肿瘤]