XELOX方案新辅助化疗对进展期胃癌疗效的Meta分析

发布时间：2018-03-27 10:19

本文选题：新辅助化疗　切入点：XELOX　出处：《皖南医学院》2017年硕士论文

【摘要】：目的:系统性评价XELOX方案新辅助化疗对进展期胃癌患者的疗效。方法:计算机全面检索:Medline、Cochrane library、CNKI、EMbase、VIP、相关期刊论文(CJFD)、中国生物医学文献数据库(CBMdisc)等中外数据库。检索日期从1989年1月至今的关于进展期胃癌患者采用XELOX方案术前新辅助化疗对比术前不接受任何形式的辅助治疗直接行手术治疗+术后化疗的所有文章。对纳入的文章使用相应的方法进行质量评定,纳入符合纳入标准的高质量的文章,所收集的数据采用Review Manager5.2进行Meta分析。结果:本研究纳入了11篇临床试验,8篇随机对照研究,3篇回顾性对照研究,一共有870例患者入选本研究,其中试验组(术前行XELOX新辅助化疗组)446例,对照组(术前不接受任何形式的辅助治疗直接行手术治疗+术后化疗组)424例。Meta分析的结果显示:术前行XELOX方案新辅助化疗的患者同单纯手术+术后化疗的患者相比总手术率R1更高(OR值为8.28,95%CI为3.58-19.15,P0.00001),根治性手术切除率R0更高(OR值为3.75,95%CI为2.67-5.28,P0.00001),1年生存率更高(OR值为2.79,95%CI为1.55-5.02,P=0.00060.05),2年生存率更高(OR值为2.78,95%CI为1.36-5.68,P=0.0050.05),3年生存率更高(OR值为2.57,95%CI为1.28-5.17,P=0.0080.05)。结论:1.术前行XELOX方案新辅助化疗的进展期胃癌患者较单纯手术+术后化疗的患者总手术率R1和根治性切除率R0更高,差异均有统计学意义。2.术前行XELOX方案新辅助化疗的进展期胃癌患者较单纯手术+术后化疗的患者1、2、3年生存率更高,差异均有统计学意义。XELOX方案新辅助化疗在临床上值得推荐。
[Abstract]:Objective: to systematically evaluate the efficacy of neoadjuvant chemotherapy with XELOX regimen in the treatment of advanced gastric cancer. Methods: the Chinese and foreign databases, such as the Chinese Journal Full-text Database, the Chinese Biomedical Literature Database and the Chinese Biomedical Literature Database, were searched by computer. All articles dated from January 1989 to present concerning the use of XELOX regimen for preoperative neoadjuvant chemotherapy in patients with advanced gastric cancer as opposed to any form of adjuvant therapy before operation, direct surgical treatment and postoperative chemotherapy. The article uses the corresponding method to evaluate the quality. The collected data were analyzed by Review Manager5.2 for Meta analysis. Results: 11 clinical trials, 8 randomized controlled trials and 3 retrospective controlled trials were included in this study. A total of 870 patients were enrolled in the study, including 446 patients in the experimental group (XELOX neoadjuvant chemotherapy before operation), The results of Meta-analysis in the control group (without any form of adjuvant therapy before operation and direct postoperative chemotherapy) showed that the patients who received neoadjuvant chemotherapy with XELOX regimen before operation were compared with those who received chemotherapy after surgery alone. The OR value higher than the total operation rate R1 was 8.28 卤95CI 3.58-19.15P0.00001, the radical resection rate R0 higher OR = 3.75-5.28P0.00001C, the one-year survival rate higher OR = 2.7995CI 1.55-5.02P0.00060.05U, the 2-year survival rate higher OR = 2.78-5.68P0.0050.05, the 3-year survival rate higher OR = 2.575.95CI = 1.28-5.175.175.02P0.005.Conclusion: the higher OR value is 1.36-5.68P0.0050.05, and the higher 3-year survival rate is 2.5795 CI = 1.28-5.175.175.02P = 0.00060.05. Conclusion: the higher OR value is 1.36-5.68P0.0050.05, and the higher OR value is 2.5795 CI = 1.28-5.175.175.02P 0.00060.05, 2.78-5.68P0.0050.05. Patients with advanced gastric cancer who received neoadjuvant chemotherapy with XELOX regimen before operation were more likely to have higher total operation rate (R1) and radical resection rate (R0) than those with postoperative chemotherapy alone. The 3-year survival rate of patients with advanced gastric cancer undergoing neoadjuvant chemotherapy with XELOX regimen before operation was higher than that of patients with postoperative chemotherapy alone. The difference was statistically significant. The neoadjuvant chemotherapy of Xerox regimen was worth recommending clinically.
【学位授予单位】：皖南医学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R735.2

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