摘要
目的通过Meta分析,探讨吉西他滨联合5-FU／卡培他滨化疗在治疗晚期胰腺癌病人中的意义。方法通过检索MEDLINE、EMBASE、ASCO论文集等数据库中国内外已发表和未发表的相关文献。收集治疗组为吉西他滨联合5-FU／卡培他滨化疗,对照组为吉西他滨单药化疗的晚期胰腺癌的随机对照试验,由2位评价者分别按上述检索策略收集资料,按纳入标准入选,主要分析指标为半年和1年生存率,次要分析指标为客观缓解率、疾病无进展生存率、临床获益反应率和毒副作用等。结果共纳入了4个临床试验,在治疗晚期胰腺癌上,吉西他滨联合5-FU或卡培他滨与吉西他滨单药相比,可以提高半年生存率10％(95％CI 0．01-0．19,P=0．03), 差异有统计学意义,但是在1年生存率、半年疾病无进展生存率、客观缓解率和临床获益反应率上并没有提高, 同时还增加了3／4级的血液学毒性及胃肠道的毒副作用。结论吉西他滨联合5-FU／卡培他滨并不能提高晚期胰腺癌病人疗效,吉西他滨单药化疗仍是晚期胰腺癌的标准治疗方案。
Objectives Using meta-analysis to explore GEM combined with 5-FU chemotherapy effects on survival and life quality in patients with inoperable pancreatic cancer. Method Search strategy： Trials from both published and unpublished sources were identified by searching MEDLINE, EMBASE, ASCO Abstracts. Selection criteria： RCT for GEM combined with 5-FU/Capecitabine and GEM alone in inoperable pancreatic cancer. Data collection and analysis： A quantitative meta-analysis using updated information basing on inclusion and exclusion criteria from all available RCT was carried out by two reviewers. The meta-analysis was based on 6 months＇ survival, 1 year＇s survival,6-month PFS,CBR,and toxicity. Results Four trials are eligible, 10% relative increase was obtained in patients with inoperable pancreatic cancer treated by GEM combined with 5-FU/Capecitabine chemotherapy compared with GEM alone on 6 months＇ survival, and the results are of statistically significant difference. But on 1-year survival, 6-month PFS, CBR, ORR, the results are of no statistical significant difference. Moreover, GEM combined with 5-FU/Capecitabine has the tendency to increase toxicity. Conchlsion There is no convincing evidence that GEM combined with 5-FU/Capecitabine can improve the chemotherapy effect compared with GEM alone. GEM alone is still the standard treatment for APCa.
出处
《循证医学》
CSCD
2006年第1期42-47,共6页
The Journal of Evidence-Based Medicine
作者简介
郭双双（1981-），女，河南洛阳人，在读硕士研究生．主要研究方向为胃肠道肿瘤的临床研究．
[通讯作者]谢德荣，中山大学附属第二医院肿瘤化疗专科．广州510120；E-mail：xiederong@21cn．com
