西妥昔单抗联合化疗治疗晚期胃癌的Meta分析

发布时间：2018-04-21 00:23

本文选题：胃肿瘤 + 西妥昔单抗　；参考：《兰州大学》2017年硕士论文

【摘要】：目的:采用Meta分析系统评价西妥昔单抗联合化疗治疗晚期胃癌的有效性及安全性。方法:计算机检索万方、知网、中国生物医学文献、维普、PubMed、Cochrane Library、EMBASE、Web of Science。收集国内外公开发表的有关西妥昔单抗联合化疗治疗晚期胃癌的相关研究。对纳入研究行方法质量学评价。采用RevMan5.3软件进行统计分析。结果:共纳入4个研究,计1152例。Meta分析结果显示,相比于单纯化疗,西妥昔单抗联合化疗在完全缓解、部分缓解、有效率以及1年生存率上无优势;进一步分析显示,联合治疗在亚洲人群中依然无生存获益;基于基因型进行亚组分析,结果显示西妥昔单抗联合化疗在HER-2阳性与阴性以及K-ras基因突变型与野生型的患者中其完全缓解率、部分缓解率和有效率的差异也不存在统计学意义。3级以上副反应,西妥昔单抗联合化疗组与单纯化疗组相比血小板减少发生率的差异不存在统计学意义,但在中性粒细胞(OR:0.64,95%CI:0.49~0.83,P=0.001)、皮疹(OR:38.96,95%CI:5.30~286.45,P=0.000)、手足综合征(OR:3.25,95%CI:1.58~6.60,P=0.001)和腹泻(OR:1.81,95%CI:1.11~2.97,P=0.020)方面差异显著。结论:西妥昔单抗联合化疗未能使晚期胃癌患者的生存获益,却增加不良反应的发生。
[Abstract]:Objective: to evaluate the efficacy and safety of cetuximab combined with chemotherapy in the treatment of advanced gastric cancer by Meta analysis system. Methods: a computer search was carried out to search Wanfang, Zhiwang, Chinese Biomedical Literature, and the Web of Science.Methods: the Chinese Biomedicine, the WebMed Medical Library and the Web of Science.Methods: a computer search was carried out. To collect domestic and international published studies on the treatment of advanced gastric cancer with cetuximab combined with chemotherapy. Quality evaluation of inclusive research methods. RevMan5.3 software was used for statistical analysis. Results: a total of 1152 patients were included in 4 studies. Meta-analysis showed that cetuximab combined chemotherapy had no advantages in complete remission, partial remission, effective rate and 1-year survival rate, compared with chemotherapy alone, and further analysis showed that cetuximab combined chemotherapy had no advantage in complete remission, partial remission, effective rate and 1-year survival rate. The results of genotypic subgroup analysis showed that cetuximab combined chemotherapy had complete remission rate in HER-2 positive and negative patients and K-ras gene mutation and wild-type patients. There was no significant difference in partial remission rate and effective rate. There was no significant difference in the incidence of thrombocytopenia between the cetuximab combined chemotherapy group and the simple chemotherapy group, and there was no significant difference in the incidence of thrombocytopenia between the two groups. But there were significant differences in the areas of the neutrophils: 0.490.49and 0.83P0. 001, the rashes OR38.96 and 95 CIW 286.45 P0.000, the palm-foot syndrome OR3.25 / 95CIW 1.583.256.60P0.001) and the diarrhea or1.8195 CI: 1.111CI: 2.97P0.020. Conclusion: cetuximab combined chemotherapy does not benefit the survival of patients with advanced gastric cancer, but increases the incidence of adverse reactions.
【学位授予单位】：兰州大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R735.2

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