GP与FP方案治疗晚期鼻咽癌疗效和不良反应的meta分析
发布时间：2018-07-21 15:23
【摘要】：背景和目的:鼻咽癌是头颈部较常见的恶性肿瘤之一,因其独特的病理类型,放射治疗具有重要的地位。鼻咽癌早期症状和体征不明显,大多数患者一旦确诊往往已是晚期。鼻咽癌的远处转移和复发严重影响了鼻咽癌患者的生存率,成为治疗失败的主要原因。如何提高鼻咽癌患者的局部控制率、减少远处转移或复发和提高总生存,已经成为当前鼻咽癌治疗的重中之重。一直以来,FP方案(氟尿嘧啶+顺铂)都作为晚期鼻咽癌的标准一线化疗方案,然而,并没有明确的循证医学证据。近年来,一些研究表明,GP方案对于晚期鼻咽癌治疗有效。所以,本文将运用meta分析的方法,比较GP方案(吉西他滨+顺铂)和FP方案(氟尿嘧啶+顺铂)治疗晚期鼻咽癌的疗效和不良反应,以期为晚期鼻咽癌患者的治疗选择提供更加科学、合理的化疗方案。方法:计算机检索PubMed、Cochrane Library、EMbase、SCI、Medcine、Ovid、CBM、CNKI、维普等数据库,同时辅助其它检索方式(截止到2016年7月),纳入GP和FP方案比较治疗晚期鼻咽癌的临床随机对照试验(RCTs),按照Jadad质量计分法对纳入的每篇文献进行方法学质量评估,使用RevMan5.3软件进行统计学分析。结果:使用计算机检索相关中英文数据库,共纳入符合标准的文献14篇,包括10篇中文和4篇英文,共1253例晚期鼻咽癌患者,其中GP组607例,FP组646例。利用RevMan5.3软件对收集的数据进行统计学分析,结果显示:GP方案和FP方案相比,在治疗晚期鼻咽癌疗效方面:1年生存率(RR=1.07,95%CI:1.01~1.13,p=0.03)、3年生存率(RR=1.20,95%CI:1.07~1.33,p=0.001)和客观缓解率(RR=1.23,95%CI:1.09~1.40,p=0.0009)有统计学差异,说明GP方案优于FP方案;在不良反应方面:血液学毒性无明显统计学差异(p≥0.05);消化道反应(恶心、呕吐)相对较低(p0.00001)。结论:GP与FP方案相比,具有较好的疗效和更轻微的毒副作用,结合之前学者的临床试验结果,可考虑将GP方案作为晚期鼻咽癌的一线治疗方案。该结论有待于进一步加大样本量进行证实。
[Abstract]:Background and objective: nasopharyngeal carcinoma (NPC) is one of the most common malignant tumors in head and neck. The early symptoms and signs of nasopharyngeal carcinoma are not obvious, and most patients are usually late once diagnosed. Distant metastasis and recurrence of nasopharyngeal carcinoma (NPC) have seriously affected the survival rate of NPC patients and become the main cause of failure in treatment. How to improve the local control rate, reduce distant metastasis or recurrence and improve the overall survival of nasopharyngeal carcinoma patients has become the most important treatment of nasopharyngeal carcinoma. FP regimen (fluorouracil cisplatin) has been used as the standard first-line chemotherapy regimen for advanced nasopharyngeal carcinoma, however, there is no clear evidence-based medical evidence. In recent years, some studies have shown that GP regimen is effective in the treatment of advanced nasopharyngeal carcinoma. Therefore, meta analysis was used to compare the efficacy and side effects of GP regimen (gemcitabine cisplatin) and FP regimen (fluorouracil cisplatin) in the treatment of advanced nasopharyngeal carcinoma. In order to provide a more scientific and rational chemotherapy regimen for patients with advanced nasopharyngeal carcinoma. Methods: a computer-based search was made for the database of PubMedus Cochrane Library EMbase, SCI, Ovidine, CBM, CNKI, etc. At the same time, other retrieval methods (as of July 2016) were included in the clinical randomized controlled trial (RCTs), which included GP and FP schemes for the treatment of advanced nasopharyngeal carcinoma, and were evaluated according to Jadad quality scoring method for each article included. The software Revman 5.3 was used for statistical analysis. Results: a total of 14 articles including 10 Chinese and 4 English were included in the relevant Chinese and English databases. 1253 patients with advanced nasopharyngeal carcinoma were included in this study, including 607 patients in GP group and 646 in FP group. The data collected were statistically analyzed with RevMan5.3 software. The results showed that the 1-year survival rate (RRR1.0795 CI: 1.01C: 1.13p0.03), the 3-year survival rate (RRRR1.20c95CIW 1.071.33 p0.001) and the objective remission rate (RRR1.2395 CI: 1.09: 1.40p0.0009) were significantly different in the treatment of advanced nasopharyngeal carcinoma compared with FP regimen. The results showed that GP regimen was superior to FP regimen in side effects: hematological toxicity was not significantly different (p 鈮，
本文编号：2135955
[Abstract]:Background and objective: nasopharyngeal carcinoma (NPC) is one of the most common malignant tumors in head and neck. The early symptoms and signs of nasopharyngeal carcinoma are not obvious, and most patients are usually late once diagnosed. Distant metastasis and recurrence of nasopharyngeal carcinoma (NPC) have seriously affected the survival rate of NPC patients and become the main cause of failure in treatment. How to improve the local control rate, reduce distant metastasis or recurrence and improve the overall survival of nasopharyngeal carcinoma patients has become the most important treatment of nasopharyngeal carcinoma. FP regimen (fluorouracil cisplatin) has been used as the standard first-line chemotherapy regimen for advanced nasopharyngeal carcinoma, however, there is no clear evidence-based medical evidence. In recent years, some studies have shown that GP regimen is effective in the treatment of advanced nasopharyngeal carcinoma. Therefore, meta analysis was used to compare the efficacy and side effects of GP regimen (gemcitabine cisplatin) and FP regimen (fluorouracil cisplatin) in the treatment of advanced nasopharyngeal carcinoma. In order to provide a more scientific and rational chemotherapy regimen for patients with advanced nasopharyngeal carcinoma. Methods: a computer-based search was made for the database of PubMedus Cochrane Library EMbase, SCI, Ovidine, CBM, CNKI, etc. At the same time, other retrieval methods (as of July 2016) were included in the clinical randomized controlled trial (RCTs), which included GP and FP schemes for the treatment of advanced nasopharyngeal carcinoma, and were evaluated according to Jadad quality scoring method for each article included. The software Revman 5.3 was used for statistical analysis. Results: a total of 14 articles including 10 Chinese and 4 English were included in the relevant Chinese and English databases. 1253 patients with advanced nasopharyngeal carcinoma were included in this study, including 607 patients in GP group and 646 in FP group. The data collected were statistically analyzed with RevMan5.3 software. The results showed that the 1-year survival rate (RRR1.0795 CI: 1.01C: 1.13p0.03), the 3-year survival rate (RRRR1.20c95CIW 1.071.33 p0.001) and the objective remission rate (RRR1.2395 CI: 1.09: 1.40p0.0009) were significantly different in the treatment of advanced nasopharyngeal carcinoma compared with FP regimen. The results showed that GP regimen was superior to FP regimen in side effects: hematological toxicity was not significantly different (p 鈮，
本文编号：2135955
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